Background & Traumatology

What is trauma?

• Webster’s Dictionary defines it as… “A very difficult or unpleasant experience that causes someone to have mental or emotional problems, usually for a long period of time.”

• Origin of TRAUMA: Greek traumat-, trauma wound

• First known use: circa 1693

• Practical translation? LIFE

• “Trauma is a threat we’re not prepared to handle.” Jaak Panksepp

 

The DSM-V definition of trauma

• Criterion A: stressor – the person was exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence

• Criterion B: intrusion symptoms – the traumatic event is persistently re-experienced

• Criterion C: avoidance – persistent effortful avoidance of distressing trauma-related stimuli after the event

• Criterion D: negative alterations in cognitions and mood – that began or worsened
after the traumatic event

• Criterion E: alterations in arousal and reactivity – trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event

• Criterion F: duration – six months post trauma

• Criterion G: functional significance – significant symptom-related distress or functional impairment, e.g., social, occupational

• Criterion H: exclusion – disturbance is not due to medication, substance use, or other illness

How do we “interpret” trauma?

• Mol, S.S., Arntz, A, Metsemakers, J.F., Dinant, G.J., Viters-Van Montfort, P.A., &
Knottnerus, J.A. (2005).

• Higher disturbance scores after life events (“t”) than after traumatic events (“T”); survey of 832 people for events within past 30 years

• “t” trauma is any disturbing life experience

• “T” trauma meets the DSM-IV-V criteria for PTSD

• Hasse, M., Balmaceda, U.M., Ostacoli, L., Liebermann, P., and Hofmann, A. (2017)

• Pathogenic memories are not necessarily linked to PTSD criterion A event, but may be linked with other mental disorders. The issue is the pathology developing after an event

• Intense feelings of helplessness or misinterpretations of an event

• Absence of an attachment figure impairs information processing

• Can explain development and progress of depression, addiction, etc.