Trauma and stressor disorders are a relatively recent category of the DSM which refers to disorders, traditionally belonging to those of anxiety, caused by traumatic events.
Among these disorders we have some well known ones, like PTSD, and others associated with dysfunctional inclination or personality traits.
Below, we’ll take a closer look at this category of such a long title, along with its history and the troubles that go into it.
Trauma and Stressor Disorders: Characteristics
Trauma and stressor-related disorders are a set of mental disorders in which exposure to a traumatic or very stressful event is one of their main diagnostic criteria.
Currently, a stressor is any stressor that disrupts a person’s normal physiological, cognitive, behavioral or emotional balance. The origin of this stressor can be of a different nature and can be physical, economic, social or psychological.
For its part, a traumatic factor is any event that it can cause serious harm to the physical and psychological integrity of the person, Already in the form of a threat of death, serious harm, sexual violence, both in the same person and in a relative or friend.
Disorders in this category have a high personal, economic and social cost. On a personal level, they cause discomfort, suffering and a series of post-traumatic sequelae so severe that they can leave a mark on the person for life. Economically, trauma and stressor-related disorders represent a major expense for state institutions and enterprises, as those who suffer from them seek long-term sick leave and disability pensions.
From a social point of view, disorders in this category have been of great concern. This has been particularly the case in the Western world over the past two decades following events as traumatic as September 11, September 11, and other attacks by Islamists and separatist paramilitary groups (e.g. ETA , IRA and pro-Russian Crimean Militias).
This is why developed countries, especially Western Europe and the United States, designed and implemented it. programs to reduce the incidence of these disorders and mitigate the consequences.
Since the publication of the fifth edition of the DSM (2013), trauma and stressor disorders have their own specific section, being formally separated from anxiety disorders, and asserting themselves as one of the major groups of psychiatric disorders.
As for the other major classification system for mental disorders, these disorders have already benefited from their own distinct group, since the publication of ICD-10 in 1992, it is only here that they are called stress reactions. severe and mentally disturbed.
They can also be found, in part, in the personality disorders section of the ICD-10 itself. There, the existence of calls is recognized Persistent personality transformations after a catastrophic experience (PPT), In which the consequences of a traumatic event are so devastating that they manifest themselves even decades after you have been exposed to the traumatic event. To be diagnosed, the event must have been so extreme that it did not require personal vulnerability to explain the profound effect on the personality.
Major disorders in this category
Below we will see the main disorders that make up the category of trauma and stressor disorders.
1. Reactive affective disorder (RAD)
Reactive state disorder (RAD) occurs at about 5 years of age, with the main feature a socially distorted and unduly developed relationship capacity in most contexts.
Among the general characteristics that we can find in this disorder, we have bad social or emotional reactions towards others, very limited expressions of positive affection, and episodes of irritability, sadness or fear for no apparent cause or reason.
Children who exhibit stress disorder have experienced some extreme types of inadequate care at some point in their lives. Whether through negligence or social lack, they did not have their basic emotional needs covered, Prevent the child from growing up feeling safe.
2. Uninhibited disorder in social relations
Uninhibited social disorder also occurs in children. The little one shows blind sociability or lack of selectivity in the choice of figures to be respected.
Children with this disorder exhibit overly familiar verbal or physical behavior with people outside of their immediate circle, in addition to seeking emotional contact with strangers. For example, they are too familiar with strangers, whom they can ask for things and show them affection.
The funny thing is that they have little or no recourse to their adult natural caregiver, that is to say to their own mother, father or guardian in charge of their care.
this disorder the uninhibited version of reactive state disorder could be considered, Having a similar origin in its appearance. Children who express this have not been able to develop a secure attachment type during their early childhood, so they develop different strategies to deal with different impairments or threatening situations.
3. Post-traumatic stress disorder (PTSD)
One of the most important trauma-related disorders, post-traumatic stress disorder (PTSD), is quite common in the population, with a prevalence of between 1 and 3.5% worldwide.
This disorder is particularly high among military personnel and others whose occupations present a high risk of exposure to traumatic events, such as police, emergency medical personnel and firefighters, as well as victims of terrorist attacks, of sexual violence and natural disasters, or to witness it.
PTSD it is associated with high rates of social, occupational and physical difficulties, As well as high economic costs and increased use of medical services.
Among the most notable causes of this disorder we have:
- Flashbacks of the traumatic event.
- Difficulty sleeping and nightmares.
- Feelings of loneliness.
- Excessive reactivity: irritability, aggressiveness, hypervigilance …
- Mood swings, as well as worry, guilt, and sadness.
- Intrusive thoughts.
- Avoidance of memories.
- Cognitive impairments, such as irrational fears.
- Depersonalization: feeling of being an observer outside oneself.
- Unrealization: feeling that the world you live in is unreal.
4. Acute stress disorder
This disorder is characterized by the appearance of a set of symptoms of anxiety that occur after being exposed to a highly traumatic event.
These changes last for more than two days, up to a maximum of four weeks, and appear within the first month after the traumatic event has been experienced. If these four weeks are passed, the diagnosis of PTSD or adjustment disorder will be considered.
The most common symptoms of this disorder are similar to those of PTSD:
- Unrealization: feeling that the environment is unreal or strange.
- Dissociative amnesia: inability to remember the traumatic event.
- Lack of concentration.
- Sleep reconciliation problems.
- Behaviors to avoid people or places associated with trauma.
One of the differences when it comes to PTSD is that acute stress disorder is earlyThat is, it begins to be felt soon after being exposed to the traumatic event.
5. Adjustment disorder
Adjustment disorder is a symptomatic manifestation derived from a clear and defined stressful event, Which lasts three months after onset on its own, but which cannot be classified as TEPT.
To be diagnosed there must have been an extremely high level of discomfort, disproportionate to what one would expect of how a person would react without the disorder to the same stressful event, and which would result in deterioration of labor and of the social domain.
There are several subtypes including adjustment disorder with:
- Depressed mood: hopelessness and sadness.
- Anxiety: nervousness, restlessness and fear.
- Anxiety associated with depressed mood: combination of the above.
- Antisocial: aggressiveness and impulsiveness.
- Emotional and antisocial mixture: combination of sadness and fear with aggression.
Whatever the modality, this disorder involves all kinds of problems, Such as marital and family problems, sexual dysfunctions, financial difficulties, poor school performance, health problems and job changes.
6. Other trauma-related disorder and specified and unspecified stressors
This category is used to denote disorders in which symptoms characteristic of trauma-related disorders and stressors predominate, causing clinically significant discomfort as well as social, occupational and economic impairment, but which they do not meet the diagnostic criteria sufficient to have a pure diagnosis.
- American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- World Health Organization (1992). International Classification of Diseases and Health Problems, Tenth Revision (ICD-10). Geneva, Switzerland.
- Morales Rodríguez, PP, Medina Amor, JL, Gutiérrez Ortega, C., Abejaro de Castro, LF, Hijazo Vicent, LF and Losantos Pascual, RJ. (2016). Trauma and stressor related disorders within the Spanish Military Health Psychiatric Expert Council. Military Health, 72 (2), 116-124.