Article

Progress and Controversy in the Study of Posttraumatic Stress Disorder

Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, Massachusetts 02138, USA.
Annual Review of Psychology (Impact Factor: 21.81). 02/2003; 54(1):229-52. DOI: 10.1146/annurev.psych.54.101601.145112
Source: PubMed

ABSTRACT

Research on posttraumatic stress disorder (PTSD) has been notable for controversy as well as progress. This article concerns the evidence bearing on the most contentious issues in the field of traumatic stress: broadening of the definition of trauma, problems with the dose-response model of PTSD, distortion in the recollection of trauma, concerns about "phony combat vets," psychologically toxic guilt as a traumatic stressor, risk factors for PTSD, possible brain-damaging effects of stress hormones, recovered memories of childhood sexual abuse, and the politics of trauma.

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    • "Based on this research, definitions of PTSD (reviewed below) have evolved over time: many have advocated for a more inclusive definition of trauma (e.g., Avina and O'Donohue, 2002;Butts, 2002) that encompasses both extreme events that are traditionally viewed as traumatic (e.g., combat, interpersonal violence) and events that are traditionally viewed as stressful life events (e.g., sexual harassment, divorce, chronic illness, racial discrimination; seeRosen & Lillienfeld, 2008for a review). Others have advocated for a more restrictive definition (McNally, 2003;Rosen, 2004), and/or for completely eliminating the need to objectively define a traumatic event (Brewin, Lanius, Novac, Schnyder, & Galea, 2009). To some extent, this is a question of deciding on the purpose of the criterion: whether to capture all events that may precipitate PTSD, thus capturing more individuals who may be eligible for PTSD-related treatment or services, or whether to be more restrictive so as to capture only those with the most severe cases (Kilpatrick, Resnick, & Acierno, 2009). "
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    • "As the trauma literature has matured, many research groups have noted that trauma is not easily defined by a specific event, such as an earthquake, fire, or assault (Berger et al., 2012; Kilpatrick et al., 2013). Similarly, several research groups have criticized the definition based on distress alone (Rosen, 2004; McNally, 2003), arguing that those responding with Posttraumatic Stress Disorder (PTSD) like symptoms to a minor event are a separate group and should not be considered " traumatized. " A strong theme in trauma definition work in recent years has been the role of meaning, going back to Freud's definition of trauma as being in excess of the ego's ability to cope. "
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    ABSTRACT: Information Deprivation Trauma (IDT; Schild & Dalenberg, 2012b) is a concept that has not been adequately addressed in the trauma literature. IDT is a concept requiring a negative emotional response (e.g., fear, helplessness, horror) consequent to (a) a lack of understanding of the extent/magnitude/consequences/probability of a current or impending meaningful event and (b) an inability to access information about this event that would reasonably allow a person to prepare, appropriately respond, and/or self-protect. Arguments are presented that information deprivation itself may constitute a trauma, in addition to and apart from the possibility that information deprivation may enhance vulnerability to traumatization. Clinical examples are provided and the Information Deprivation Trauma Interview (IDTI) is introduced for use in clinical and research settings. http://svenschild.com/IDT.html
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    • "cesses that produce sensory details that are not well integrated conceptually (e.g., Brewin, Dalgleish, & Joseph, 1996; Ehlers & Clark, 2000; Horowitz, 1976; for reviews from various perspectives , see Brewin & Holmes, 2003; Dalgleish, 2004; McNally, 2003a, b; Porter & Birt, 2001; and Shobe & Kihlstrom, 1997). According to an alternative view, incoherence can be understood in terms of cognitive and affective processes that have been developed to account for memory in general. "
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