Harold G. Koenig
in Moral injury
American psychiatrist (MD, MHSc), Professor of Psychiatry & Behavioral Sciences and Associate Professor of Medicine at Duke University Medical Center, and director of Duke's Center for Spirituality, Theology and Health. Long career in the religion-and-mental-health subfield — over 600 publications, much of it on the relationship between religious practice and outcomes in depression, anxiety, and dementia. Came to moral injury through that route rather than through the combat-trauma route.
Stake§
Koenig's prior work is openly invested in the claim that religious practice has measurable mental-health benefits, which is contested in mainstream psychiatry. The stake on moral injury is consonant: his MISS-M scale explicitly includes religious struggle, loss of faith, and difficulty forgiving as measurement subscales, and his framing of the construct gives spiritual content a more central place than the Litz framework does. Critics inside the measurement subfield have flagged this as theory-laden measurement; sympathetic readers see it as a corrective to a field that has too readily stripped the religious content out of a phenomenon whose own subjects describe it in religious terms.
Koenig is first author on the 2018 Journal of Religion and Health article that introduced the Moral Injury Symptom Scale — Military Version (MISS-M), a 45-item, ten-subscale instrument developed in a multi-site VA study of 427 veterans and active-duty service members with PTSD. The scale's distinctive feature is the explicit inclusion of religious-struggle subscales alongside the standard guilt/shame/meaning/trust ones.
Within the moral-injury measurement subfield Koenig is the counterpart to Currier — both have validated instruments in active use, but the Koenig scale operationalises a more theologically inflected version of the construct.