Trauma and Abuse

    Definitions

    Psychological Abuse

    Psychological abuse is "interactions in which one person behaves in a violent, demeaning or invasive manner towards another person (e.g. child or partner)"  — APA Dictionary of Psychology

    Psychological Trauma

    Trauma can be understood as the experience of being made into an object; the victim of someone else's rage, of nature's indifference, or of one's own physical and psychological limitations.

    Along with the pain and fear associated with rape, combat trauma, or natural disaster come a marginally bearable sense of helplessness, a realization that one's own will and wishes become irrelevant to the course of events, leaving either a view of the self that is damaged; contaminated by humiliation, pain, and fear that the event imposed, or a fragmented sense of self."  — David Spiegel

    What is Traumatic Stress?

    Traumatic stress is extreme stress that overwhelms a person's ability to cope. [5]

    Causes of Trauma

    Many different types of experience can lead to psychological trauma. Some examples of experiences which cause psychological trauma include:

    • accidents, e.g. motor vehicle accidents
    • natural disasters, e.g. hurricanes, earthquakes
    • interpersonal violence, e.g. robbery, rape and homicide and urban violence
    • surgery and serious physical illness
    • chronic or repetitive experiences such as child abuse and neglect
    • war or living in a war zone, military combat, concentration camps
    • enduring deprivation [2]

    Different Types of Trauma - Type I and Type II

    Trauma can also be classified into type forms, Type I and Type II trauma (Terr, 1991). The type of trauma a person experiences is one of a number of factors that determine the impact of the trauma, including how likely it is that the person will develop Posttraumatic Stress Disorder (PTSD) or Complex PTSD (C-PTSD).

    Type I Trauma

    • Single-incident trauma, e.g. a sudden and unexpected trauma, a single episode or experience of trauma.
    • Lower risk of Posttraumatic Stress Disorder developing when compared with Type II trauma [3]:15

    Type II trauma (Complex Trauma)

    • involves complex or repetitive trauma
    • this "usually involves a fundamental betrayal of trust in primary relationships" because it involves a perpetrator known to the victim
    • often this is interpersonal trauma, carried out by a person known to the victim.
    • Affects between 1 in 7 and 1 in 10 children
    • More often occurs in combination with other traumas, or in many different types of circumstances (known as "polyvictimization")
    • Involves a far higher risk of Posttraumatic Stress Disorder developing than single traumas.
    • Symptoms and difficulties caused by complex trauma may extend well beyond the symptoms of PTSD, and result in the extra symptoms found in and other diagnoses, for example personality disorders, for example giving an overall impression of mental illness with the posttraumatic nature being lost or going unrecognized [3]:15-17
    • Difficulty managing emotions (difficulties with affect regulation) often results from complex trauma [17]

    PTSD Risk Hierarchy

    Different traumatic experiences are associated with different chances of developing post-traumatic symptoms because the effect on a person depends on the type and severity of the trauma. [7]:74 A theoretical hierarchy of traumatic experiences reflects this. [8]:147

    Different Types of Trauma and Abuse

    • Child abuse (maltreatment)
    • Childhood neglect
    • Sexual abuse, including rape and sexual assault
    • Physical abuse
    • Emotional abuse
    • Psychological abuse
    • Financial abuse
    • Organized abuse
    • Ritual abuse
    • Domestic violence (Intimate Partner Violence)
    • Elder abuse
    • Exploitation including trafficking

    Dissociation after trauma

    Dissociation is a common experience after trauma, and some symptoms of PTSD are dissociative in nature, for example flashbacks and emotional numbing. There is also a dissociative subtype of PTSD that involves depersonalization or derealization caused by trauma triggers. Dissociation that is problematic and either lasts for a long time or keeps reoccuring over a long period of time, and is independent of PTSD symptoms, may be the result of a dissociative disorder. [2]:271-281, 291, [17]

    See also


    Late updated 2023.

    References

    1. World Health Organization. (2010) ICD-10 Version: 2010. Retrieved December 7, 2014, from https://apps.who.int/classifications/icd10/browse/2010/en#
    2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). Washington, D.C.: American Psychiatric Association. ISBN 0890425558.
    3. Courtois, Christine A. and Ford, Julian D. (Eds) (2009). Treating Complex Traumatic Stress Disorders (Adults): Scientific Foundations Foundations and Therapeutic Models. Guilford Press. ISBN 1606237322.
    4. Doctor, R., & Shiromoto, F. (2009). The Encyclopedia of Trauma and Traumatic Stress Disorders. Facts on File. ISBN 0-8160-6764-3.
    5. Giller, Esther. What is psychological trauma. Sidran Institute (1999).
    6. VandenBos, Gary R. (Ed) (2006). APA Dictionary of Psychology. American Psychological Association. ISBN 1591473802.
    7. Howell, Elizabeth F. (2011). The Treatment of Dissociative Identity Disorder: A Relational Approach. ISBN 1135845832.
    8. van der Kolk, Bessel A., McFarlane, Alexander C. , Weisaeth, Lars (Eds). (2012). The Effects of Overwhelming Experience on Mind, Body, and Society. Guiford Press. ISBN 1462507107.
    9. Schwarz, Robert (2013). Tools for Transforming Trauma. ISBN 1135057222.
    10. Spiegel, David (1990). Hypnosis, dissociation, and trauma: Hidden and overt observers. In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health (pp. 121-142). Chicago: University of Chicago Press. ISBN 0226761061.
    11. Marzillier, John (2012). To Hell and Back: Personal Experiences of Trauma and How We Recover and Move on. Constable & Robinson. ISBN 1780337841.
    12. Wheeler, Kathleen (2008). Psychotherapy for the Advanced Practice Psychiatric Nurse. Mosby, Inc. ISBN 978-0-323-04522-3.
    13. Kaslow, Florence W., Patterson, Terence Ph.D (2004). Comprehensive Handbook of Psychotherapy. ISBN 0-4712-1100-1.
    14. Gordon, Nirit (2013). The Dissociative Bond. Journal of Trauma & Dissociation, 14(1), 11-24. (doi:10.1080/15299732.2012.694595)
    15. Lanius, Ruth A., Vermetten, Eric, and Pain, Clare (2010). The impact of early life trauma on health and disease: The hidden epidemic. Cambridge University Press. ISBN 9780521880268.
    16. Terr, L. C. (1991). Childhood traumas: An outline and overview. American Journal of psychiatry, 148(1), 10-20.
    17. World Health Organization. (2023) ICD-11. Version: 01/2023. Retrieved May 5, 2023, from https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f585833559
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