Moral injury is the profound psychological distress which can arise following participating in, or witnessing, events which transgress an individual’s morals and include harming, betraying, or failure to help others, or being subjected to such events, e.g. being betrayed by leaders. It has been primarily researched in the military, but it also found in other professionals such as healthcare workers coping with the COVID-19 pandemic and civilians following a wide range of traumas.

Moral injury merits further study to clarify its identification, prevalence, assessment and intersection with psychosocial and psychiatric problems. The present study investigated the screening potential of the Brief Moral Injury Screen (BMIS) in a sample of post‐9/11 veterans (N = 315) and comparatively evaluated how this tool, the Moral Injury Events Scale (MIES), and the Moral Injury Questionnaire‐Military Version (MIQ‐M) relate to psychiatric diagnoses and mental illness symptom severity.

Moral injury and Post-Traumatic Stress Disorder (PTSD) are two prominent mental health problems that affect military personnel. Moral injury results when the individual is exposed to a situation or event that violates their moral code; however, PTSD results when there is a substantial threat of harm. Moral injury is a relatively new construct within the literature with research starting in the late 2000s. Although distorted cognitions are core components of PTSD symptomatology, there has been no research of cognitions in moral injury.

Epigenetic differences may help to distinguish between PTSD cases and trauma-exposed controls. Here, we describe the results of the largest DNA methylation meta-analysis of PTSD to date. Ten cohorts, military and civilian, contribute blood-derived DNA methylation data from 1,896 PTSD cases and trauma-exposed controls. Four CpG sites within the arylhydrocarbon receptor repressor (AHRR) associate with PTSD after adjustment for multiple comparisons, with lower DNA methylation in PTSD cases relative to controls.