Development and Preliminary Evaluation of the Moral Injury Assessment for Public Safety Personnel

Public safety personnel (PSP) are required to make decisions that can violate their moral standards, and they and are also disproportionately exposed to other morally challenging events that may increase their vulnerability to experiencing moral injury (MI). Yet, there is little research exploring moral pain in PSP and no existing instruments to identify MI in PSP. Here, the Moral Injury Assessment for PSP was developed and piloted with 270 Canadian and American PSP. Factor analytic results revealed 3 distinct factors related to the experience of MI for PSP: Perpetrations, Betrayals, and Emotional sequelae. The emergence of these factors replicates the perpetration and betrayal dimensions of MI established in other populations and adds to the emerging body of literature seeking to identify a consistent symptom profile of MI. Our results preliminarily suggest strong reliability (i.e., internal consistency and item-total correlation) and excellent construct validity when compared with other measures of psychological stress. This work advances our understanding of MI and the unique challenges experienced by PSP and highlights the need for future work aimed at assessing and treating MI in PSP populations.