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Trauma treatment

Introduction to trauma

Trauma is an experience that is emotionally painful, distressful or shocking, which often results in lasting mental and physical effects. (Note: We address only psychological trauma, not physical injury, although physical injury can lead to emotional or psychological trauma responses.) Trauma involves an event (or repetitive events) and a reaction or response that includes an overwhelming experience of helplessness or powerlessness.

Types of trauma and their effects

Three main categories of traumatic events can each lead to a different trauma response and respond to a different form of treatment:

  • recent acute traumatic events (e.g., car crash, violent assault)
  • past single traumatic events (e.g., rape, death of spouse, accident) and events that last a period of time (e.g., a natural disaster or outbreak of political violence or war)
  • long-term chronic abuse (e.g., ongoing childhood sexual or other abuse, including neglect; growing up in violent environment).

Simple versus complex post-traumatic stress disorder

Experiencing traumatic events can lead to a person developing simple or complex post-traumatic stress disorder (PTSD).

  • Recent acute traumatic events or past single traumatic events are most likely to lead to simple PTSD.
  • Long-term chronic trauma including sexual abuse can lead to  problems that are difficult to treat and can involve more complex, psychosocial factors that affect a person's ability to form healthy, trusting relationships. In 1992 Judith Herman proposed a new diagnosis to describe the symptoms related to chronic trauma; complex PTSD (Herman, 1992).

A diagnosis of complex post-traumatic stress disorder, has been proposed for the International Classification of Diseases, 11th edition (ICD-11) which is due to be published in 2017.

Although the Diagnostic and Statistical Manual 5 (DSM 5) does not include a complex post-traumatic stress disorder diagnosis,  a new diagnostic category, "Trauma and Stressor Related Disorders" was added. Highlights of Changes from DSM-IV-TR to DSM 5 summarizes these changes. 

Literature on DSM-5 and ICD-11 summarizes the research, reviews and position papers that informed the development of the DSM 5 and ICD-11 criteria.

Effects of trauma

Trauma can affect people emotionally, cognitively, physically and socially. For an overview of the effects of trauma (also called trauma responses), see the following online public information brochures:

Identifying the need for trauma treatment

Criteria for identifying or diagnosing simple or complex post-traumatic stress disorder (PTSD) are different, as are the treatments. It is also important to determine whether clients need more help stabilizing and controlling their responses.

References 

Herman, JL (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5 (3), 377-391.


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