07/10/2026
What exactly is moral injuryβand how do we measure it?
As conversations about first responder and military mental health continue to evolve, **moral injury** has become an increasingly important topic. But before we can understand it, treat it, or study it, we need reliable ways to measure it.
A 2025 systematic review and meta-analysis by Griffin and colleagues examined the outcome measures used to assess moral injury across research and clinical settings.
The review found that while multiple assessment tools exist, they differ in what they measure, how they define moral injury, and the populations for which they were developed. This highlights both the progress made in the field and the ongoing need for consistent, validated measures.
The authors identified several common dimensions of moral injury:
βοΈ Guilt
π Shame
π Betrayal
π§ Violations of deeply held moral values
π€ Loss of trust
β Spiritual or existential conflict
Unlike PTSD, which is often rooted in fear after a traumatic event, moral injury centers on violations of one's moral beliefs or values. It may occur after actions taken, actions not taken, or feeling betrayed by leaders or organizations.
The review also emphasized that measuring moral injury accurately is essential for:
β
Advancing research
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Improving clinical care
β
Evaluating treatment effectiveness
β
Better understanding first responder and military experiences
As someone whose work increasingly focuses on preventive mental wellness and moral injury among first responders, I find this review especially valuable. It reminds us that before we can effectively address a problem, we must first understand how to identify and measure it.
As research continues to evolve, so will our ability to recognize moral injury earlier, provide more targeted interventions, and build healthier organizations.
π¬ Do you think moral injury is receiving enough attention in first responder wellness discussions?
**Article Citation:**
Griffin, B. J., Price, L. R., Jenkins, Z., Litz, B. T., & Maguen, S. (2025). *A systematic review and meta-analysis of moral injury outcome measures.* *Current Treatment Options in Psychiatry, 12*(1), Article 7. https://doi.org/10.1007/s40501-024-00342-9