A Guide to Understanding Trauma
Here are some information on trauma as well as articles pertaining to different issues that cause the condition. This will help you understand any warning signs or symptoms that eventually lead to the situation. Please refer to our other resources on the different areas of psychology as your continue your research and studies.
Trauma is known as emotional, or psychological injury that results from extremely stressful or life threatening situations. From an evolutionary standpoint, it may be that trauma originated in order to warn us of life or death situations and help us avoid harm. However, there remains evidence that those who experience mental abuse that is not necessarily life threatening also show symptoms of trauma. Traumatic experiences test our personalities, and challenge our beliefs. Yet, we give meaning only related to the context of events we experience. This means that people’s reactions to trauma will remain highly subjective. We experience trauma in many ways and are also affected in as many ways depending upon individual characteristics and environmental stressors. Prior history can result in a more severe case of PTSD, while potentially, taking advantage of certain stress coping methods may allow us to fight against it. Post-traumatic Stress Disorder is a prevalent traumatic disorder experienced by many, and drastically affects one’s ability to live comfortably. The nightmarish symptoms of this disorder inspire us to further investigate and explain how PTSD operates, and what can be done to reduce its effect.
Due to its severity trauma may be distressing, however, it is important to remember that traumatic disorders and reactions are typical and healthy responses to events that are out of the ordinary. The following text and articles should present to you what PTSD is, how it works, and who is most affected. It should also provide resources for you to further your understanding of similar traumatic disorders, or perhaps more importantly explore the implications of such psychological experiences.
Post-traumatic Stress Disorder (PTSD) is the most common category used to describe symptoms of emotionally traumatic experience. Often, traumatic events including actual or threatened death or injury inducing fear or horror result in this disorder. The diagnostic criteria for this disorder involve three specific symptom clusters: Intrusions, Avoidance, and Hyperarousal. Furthermore, PTSD may result when symptoms persist for more than one month after a traumatic event.
The first symptom cluster, Intrusion, involves the re-living of the traumatic experience and may include flashbacks or nightmares. Avoidance is seen when an affected person attempts to reduce their exposure to things that may incite intrusive symptoms. Thirdly, Hyperarousal, refers to physiologic indications of increased arousal including startle response. The actual, more specific, symptoms of PTSD are explained in the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM. It is important to keep in mind the one month duration requirement of these symptoms, others who experience these symptoms may suffer from Acute Stress Disorder, which applies to recent trauma.
Traumatic symptoms are most likely the result of evolution, and are meant to allow us to recognize and avoid dangerous situations. These symptoms can sometimes resolve within a number of days or sometimes weeks of a traumatic event. It is when symptoms persist for months or with great intensity that professional help may be necessary.
Unlike many traumatic disorders, PTSD is experienced differently by many people. This may be the result of differing stressors. Other traumatic disorders such as Depression, Anxiety and Dissociation may result instead of PTSD depending on how an individual deals with their stress, or even how the individual interprets the stress experienced. Individual differences can affect the intensity of symptoms as well as the type of symptoms experienced.
Dissociation is a common coping method used when faced with intense stress, but severe dissociative tendencies can be pathological. In such extreme cases, Dissociative Identity Disorder (DID) may result. Specialists believe this condition requires specific treatment. If PTST is to be considered a dissociative disorder then, it should be approached in the specifically outlined way. Some argue that screening for suspected dissociative disorders may be possible due to a separate taxon of pathological dissociation.
As exposure to trauma increases, so too does risk for developing PTSD. Chronic or multiple traumatic experiences are much more difficult to overcome than many single instances. Estimates place incidence of PTSD at around 1% for the general population, while lifetime prevalence is estimated at 9%. The rates increase dramatically for those wounded during combat (20%) and for young adults living in inner cities (23%).
Many professionals who work with trauma victims are at-risk for secondary traumatization. This disorder can affect mental health professionals, as well as emergency workers who are exposed to overwhelming victim suffering. Although the symptoms tend to be less severe than PTSD, they still affect the livelihoods and careers of those suffering. Additionally, secondary traumatization can be found in those who are exposed to traumatic material (jurors, for instance).
The three major risk factors associated with secondary trauma include the following: exposure to images or stories of disaster victims, individual empathic sensitivity, and any related unresolved emotional issues surrounding suffering witnessed. One way to combat this is to participate in Critical Incident Stress Debriefing (CISD). These types of groups may help resolve upsetting or stressful experiences. For those suffering more severely, it may be more helpful to attend brief individual sessions.
- Ford (1999)
Disorders of Extreme Stress Following Warzone Military Trauma: Associated Features of Post-traumatic Stress Disorder (PTSD) or Comorbid but Distinct Syndromes?
This article was published in the Journal of Consulting and Clinical Psychology, 67(1), 3-12 in February of 1999.
In this article, Julian Ford explores the significant differences and similarities between Posttraumatic Stress Disorder (PTSD) and Disorders of Extreme Stress (DESNOS). These disorders are examined in a sample of 84 male military combat veterans seeking PTSD treatment. This study finds that the two disorders are comorbid, but distinct post traumatic syndromes. Ultimately, Ford finds that a combination of atrocity and early childhood trauma are best understood in terms of DESNOS. The effects of these disorders are also explored in terms of categories of assessment, classification, research and treatment.
- Ford & Kidd (1998)
Early Childhod Trauma and Disorders of Extreme Stress as Predictors of Treatment Outcome with Chronic Posttraumatic Stress Disorder
As published in the October 1998 issue of the Journal of Traumatic Stress, 11(4), 743-761.
Using adult chronic PTSD inpatients as case studies, Ford investigates DESNOS and early trauma as contributing factors in the outcome of treatment. This study finds that there may be a correlation between early trauma and a diagnosis of DESNOS, however DESNOS remains a stronger predictor of non-responsive treatment.
- Goodwin (1987)
The Etiology of Combat-related Post-Traumatic Stress Disorders
Originally appeared as a chapter in T. Williams (Ed.) Post-Traumatic Stress Disorders: a handbook for clinicians, pp. 1-18. Cincinatti, OH: Disabled American Veterans.
A detailed summary of the published chapter of a text, in it Goodwin examines the long-term effects of combat-stress for Vietnam veterans. Furthermore, he compares and contrasts the experience of combat-stress and other kinds of traumatic-stress reactions. Major sections describe common symptoms of PTSD including: depression, isolation, rage, alienation, survivor guilt, anxiety, nightmares, and intrusive thoughts.
- Friedrich, et al (1998)
Normative Sexual Behavior in Children: A Contemporary Sample
In this study, William Friedrich summarizes the normative development of sexual behaviors in children between two and twelve years. This study argues that sexual behavior is related to a large number of factors including family sexuality, family stress, family violence, maternal education and even time spent in day care.
Trauma-related Structural Dissociation of the Personality
Nijenhuis, E.R.S.; Van der Hart, O. & Steele, K. (2004). Trauma-related structural dissociation of the personality. Trauma Information Pages website, January 2004. Web URL: http://www.trauma-pages.com/a/nijenhuis-2004.php .
Nijenhuis, van der Hart, and Steele display a highly detailed explanation of structural dissociation as a result of trauma. This article considers the evolutionary and trauma related origins of structural dissociation and explains how in some cases this dissociation results in tertiary forms that are found in neglectful or of chronically abusive examples. This article also summarizes psychobiological research surrounding this theory.
- Perry (1999)
Memories of Fear
Web version of a chapter published as “The Memories of States” in J. Goodwin & R. Attias (Eds.) (1999). Splintered Reflections: images of the body in trauma. New York: Basic Books, pp. 9-38.
Perry discusses the way in which the brain “stores and retrieves physiologic states, feelings, behaviors and thoughts from traumatic events”, in order to achieve this, Perry makes use of several case studies of traumatized children and adolescents. This chapter concludes by examining the topics of vulnerable children and law as well as transgenerational memory in culture and society.
- Van der Hart & Brown (1992)
Originally published in Dissociation,1992, 6(2/3), 162-180.
The use of “abreaction” in the treatment of traumatic memories is reviewed through the examples of WWI, WWII, and the Vietnam War as well as contemporary times. Brown and van der Hart re-evaluate abreaction and find that Janet’s model of dissociation is an effective alternative for phase-oriented treatment of complex traumatic-stress disorders.
- Yehuda, et al (1998)
Phenomenology and Psychobiology of the Intergenerational Response to Trauma
Chapter 37 (pp. 639-655) Originally published in: Y. Danieli (Ed.) International Handbook: Multigenerational Legacies of Trauma. New York: Plenum Press, 1998.
In this chapter, Yehuda and colleagues provide a brief literary review on the subject of the effects of the Holocaust on its survivors as well as their offspring. They continue the chapter by examining three different approaches to studying PTSD symptoms in Holocaust survivors. Additionally, preliminary results of three in-progress studies on the subject are discussed.