Establishing Diagnostic Criteria for Moral Injury in United States Military Veterans: An Exploratory Study

Objective: A diagnostic cut-point for military veterans on a moral injury scale is lacking. The present study aims to establish such a cut-point on an existing, validated moral injury scale. Methods: Military veterans (N = 29) completed the Moral Injury Purchase Task (MIPT) and other moral injury-related outcomes (substance use, anxiety, depression, and PTSD). We conducted sensitivity and specificity analyses to determine a moral injury diagnostic cut-point based on MIPT demand intensity values. Results: Demand intensity of 30 on the MIPT exhibited an average summed sensitivity/specificity value of 1.67 across seven moral injury related outcomes, which was significantly >1.50 in a one sample t-test (t = 1.96, p = .049). Conclusions: Thus, we provide preliminary evidence for moral injury diagnostic criteria in veterans.