A critical review of the evolution and interrelation of traumatic stress disorders

Abstract

Trauma is a complex and often contentious psychopathological construct. The term trauma has become ubiquitous within mental health literature and practice. It is often used interchangeably to describe the etiology and the reaction to it. In this article we describe its historical and contemporary conceptualization through a review of the disorders that claim a direct relation to traumatic events whether or not they are recognized by official psychiatric classification systems. We critically evaluate the extent to which current understandings of traumatic stress disorders capture the diversity and complexity in trauma experiences and responses across global contexts. Post Traumatic Stress Disorder continues to be the most used clinically and most studied academically. Other diagnoses such as Ongoing Traumatic Stress Reaction and Continuous Traumatic Stress are becoming more prevalent in psychiatry, and simultaneously, Complex PTSD is challenging the way we perceive and address some personality disorders. A realignment of the definition among the various mental health professions, in addition to a comprehensive evaluation of the relevance of current classification for the nature and timeline of traumatic events, in particular in war times, would ensure better research, interventions, and, ultimately, outcomes for individuals and communities affected by traumatic events.