Moral injury from war and other severe trauma.

Moral injury (MI) is a relatively new syndrome among military personnel with symptoms of post-traumatic stress disorder (PTSD). While MI has received considerable attention in the psychological sciences, the syndrome has received relatively little notice within psychiatry. MI has been defined as the negative emotions that emerge from transgressing moral boundaries by military personnel during combat such as killing enemy combatants or innocent civilians, failing to protect innocents or fellow combatants, or observing others transgress moral boundaries. MI may also be frequent among civilians and health professionals, although, as in military personnel, is often unrecognized.