Moral Injury Test: Your Score Across Exposure, Guilt and Lost Trust

The screening has 18 statements, six for each of the three parts. Every statement is rated from strongly disagree (0) to strongly agree (4), so each part totals 0 to 24 and the whole screening totals 0 to 72. The four bands split that range into even quarters: 0 to 17, 18 to 35, 36 to 53, and 54 to 72. Those cut points are educational guides chosen for readability. They are not clinical cutoffs: this original questionnaire has no validated threshold, and moral injury is not a diagnosis with criteria to meet.

The breakdown is the part that does the work. The published instruments in this field deliberately keep two things apart: the events and how you appraise them, which is what the Moral Injury Events Scale asks about, and the expressions of injury that follow, which is what the Expressions of Moral Injury Scale measures. Summing both into one total, as this page does, is our choice and it has a cost, so the breakdown gives you the halves back. A high exposure column with a low aftermath score describes someone who went through a great deal and is, for now, carrying it; a modest exposure column with a very high aftermath score describes an injury that has taken root out of proportion to what an outside observer would call the event. Both are real, and they need different conversations.

The three groupings are our own rather than validated subscales. One thing the total cannot do is tell you whether you were actually to blame. A score here is a description of what you carry, not a verdict on what you did, and the question of responsibility is one for a person you trust rather than for an online screening.

Litz and colleagues (2009) put forward the working definition most of the field still uses: moral injury follows perpetrating, failing to prevent, witnessing or learning about acts that transgress deeply held moral beliefs and expectations. Jonathan Shay, writing earlier about Vietnam veterans, described a second route into the same damage, the betrayal of what is right by someone who holds legitimate authority, and that thread runs through the research to this day. The signature is not fear. It is guilt, shame, a sense of having been changed for the worse, loss of trust in people and institutions, a struggle with belief or meaning, and withdrawal from anyone who might see you clearly.

That is what separates it from post-traumatic stress disorder, which is organized around threat: intrusive memories, hyperarousal, avoidance of reminders, a body that will not stand down. The two travel together constantly, and the overlap is why a PTSD screen can come back high while the thing you actually cannot put down is something you did. Treatments that work on fear can also reach guilt, shame and beliefs about yourself, and some people need additional work aimed squarely at the moral side. If the pattern you recognize is the fear-and-threat side, PTSD Test (Post-Traumatic Stress Disorder) screens for it directly. If what you carry grew over years of captivity, coercion or repeated harm in a relationship, Complex PTSD Test (C-PTSD) covers the version that also damages self-worth and connection.

Moral injury is not in the diagnostic manual, and nothing on this page can diagnose anything; only a licensed clinician can assess any condition. Griffin and colleagues (2019), reviewing more than a hundred studies, found a field that agrees on the phenomenon and still disagrees about how to measure it. That is the honest state of the research, and it is a reason to treat your number here as a way to describe something rather than as a finding.

Most writing on moral injury is about combat, and for good reason: the concept was built by clinicians working with veterans, and the first scales were validated on service members. The items here cover that ground, including the orders you still cannot defend and the leadership that betrayed what it claimed to stand for. If you served, this page is for you.

It is also written for people who never wore a uniform. Clinicians and nurses who rationed care or sent someone home who should have stayed. Paramedics and firefighters who had to choose. Social workers, teachers and child-protection staff who watched a system fail a person they were responsible for. Aid workers, journalists, police, chaplains, prison staff, veterinarians. And people with no professional frame at all: a family member who made a decision about someone else's care, a parent who did not intervene, anyone who was present when something wrong happened and could not stop it. The construct does not require a battlefield, only a deeply held belief and an event that violated it.

Two boundaries. This screening is for adults looking at their own experience, not for rating anyone else's conduct, and it is not a way to decide whether someone should feel guilty. If you are being investigated or face a legal question about what happened, talk to a lawyer before you write anything down anywhere, including here. And if what you carry is mostly exhaustion and numbness from relentless exposure to other people's suffering rather than a violated belief, Compassion Fatigue Test and Burnout Test are the better fit.

The treatment research is younger than the concept, so the honest summary is that promising approaches exist and the evidence base is still growing. Adaptive disclosure, developed by Litz and colleagues for service members, works by telling the event in full to someone who will not flinch and then addressing the moral meaning directly, often through an imagined conversation with a person whose judgment matters to you. Other approaches build in acts of repair: making amends where that is possible, and where it is not, finding a form of service that answers the same debt. Both start from a position worth stating plainly, that the point is not to talk you out of your values.

Self-forgiveness is the piece people most often get wrong, including the helpers around them. It is not deciding that what happened was fine, and it is not a feeling you can argue yourself into. In the research it looks more like a sequence: naming what you actually did and did not do, separating the part that was yours from the part that belonged to the situation or to someone with authority over you, accepting the real cost, and then doing something with it.

The Self-Forgiveness Worksheet walks that sequence step by step, and Shame and Guilt Test is worth taking alongside this one, because guilt about an act and shame about being a person responds to different work.

Two practical notes. If your tradition has a structure for this, confession, atonement, teshuvah, a chaplain, use it alongside therapy rather than instead of it; many people find the moral question answered in one place and the symptoms treated in the other. And if your highest column was lost trust and withdrawal, the most useful first step is usually one honest conversation with one person who was there, or who has carried something similar, because isolation is the part of this injury that keeps the rest of it in place.