Trauma , Post- Traumatic-Stress-Disorder and Chronic Trauma
The Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR) defines trauma as:
‘the direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one’s physical integrity, or
Witnessing an event that involves death, injury or a threat to the physical integrity of another person, or
Or learning about unexpected or violent death or injury experienced by a family member or other close associate.
The person’s response to the event must involve intense fear, helplessness, or horror (or in children the, the response must include disorganised or agitated behaviour.
Potentially traumatic events may include combat, sexual and physical assault, robbery, being kidnapped,, taken hostage, disasters, motor vehicle accidents, life-threatening illnesses, witnessing death or serious injury by violent assault, accidents, childhood sexual abuse, even if it does not include actual threatening, or actual violence or injury.
Emergency workers such as firefighters, rescue workers, police officers, emergency medical and mental health workers and law enforcement personal often encounter traumatic events including fatal injuries, amputations, severe burns, serious motor vehicle accidents, etc. exposure to and witnessing of such events cause causes trauma to themselves and they may develop Vicarious Trauma.
In a study I’ve done in Scotland to establish the impact of Child Sexual Abuse work on Clinical therapist, we found that therapist’s beliefs about others the world and themselves where significantly negatively influenced by CSA work . The world is generally viewed as less safe and more threatening.
Combined and Cumulative Trauma
Victimization is a phenomenon known to clinicians who work with trauma. Children, for example, who have experiences Child Sexual Abuse, are at a greater risk to be victimised again as adults. Maladaptive behaviours following the abuse may put the child at risk of further abuse later in life.
Symptoms of Trauma or PTSD
A person who has experienced trauma may present with clinical levels of depression including Major Depression, Depression with Psychosis, Traumatic Grief; Anxiety; Panic disorder, Dissociation and Somatic responses