Commentary on the Special Issue on Moral Injury: Unpacking Two Models for Understanding Moral Injury

The most robust finding of moral injury (MI) research thus far-that past exposure to potentially morally injurious events predicts current symptoms of posttraumatic stress disorder (PTSD)-challenges conceptions that trauma is exclusively the result of fear-evoking brushes with death or sexual assault. It also calls into question the applicability to MI of treatments for PTSD grounded in the fear model of trauma. In the current article, two divergent theoretical models that have been applied to the understanding and treatment of moral injury are compared: the stress-appraisal-coping model and the stress injury model. Attention is drawn to the differences between how these models conceptualize stress and distress, including psychological trauma, and to their potential implications for the sustainment of mental health stigma, especially in military and veteran populations.