Definition of Trauma
Trauma is defined as an event, series of events, or circumstances experienced by a person as physically or emotionally harmful that have long-lasting adverse effects on the person's functioning and well-being (emotional, physical, or spiritual). 1
Key Aspects of Trauma Definition
Types of Traumatic Events
- Events involving actual or threatened death, serious injury, or sexual violence 1
- Events that can be directly experienced, witnessed, or learned about happening to close family members or friends 1
- Collective experiences affecting specific ethnic, racial, or cultural groups (intergenerational trauma) 2
Response to Trauma
- People respond differently to potentially traumatic events 1
- Trauma can result in behavioral changes that may initially help manage trauma in the short-term but can have lasting negative effects 1
- Most individuals experience at least some distressing symptoms in the aftermath of trauma exposure 3
Scope of Impact
- Affects emotional, physical, and spiritual well-being 1
- Has long-lasting adverse effects on functioning 1
- Can lead to physiological changes in brain connectivity, epigenetic patterns, and immune function 1
Trauma Symptoms and Manifestations
Immediate Responses (Common)
- Intrusive thoughts and memories about the traumatic event 1
- Avoidance of thoughts, feelings, or reminders of the event 1
- Difficulty concentrating 1
- Sleep problems, including nightmares 1
- Hypervigilance and exaggerated startle response 1
Long-Term Manifestations
- Post-traumatic stress disorder (PTSD) symptoms including:
- Intrusion symptoms (flashbacks, nightmares)
- Avoidance behaviors
- Negative alterations in cognitions and mood
- Increased arousal and reactivity 1
- Physical health problems related to chronic inflammation 1
- Increased risk for various adult illnesses 1
Special Considerations
High-Risk Populations
- Children who have experienced abuse or neglect 1
- Children in foster care or kinship care 1
- Immigrant and refugee populations 1, 2
- People living in poverty 1
- Racial, ethnic, and religious minorities experiencing discrimination 1, 2
- LGBTQ individuals 1
- Military families 1
Intergenerational Trauma
- Collective, transgenerational emotional and psychological injury 2
- Affects descendants of groups who experienced major events of oppression 2
- Linked to current health and behavioral disorders including substance use disorder, domestic violence, and suicide 1
Clinical Implications
Assessment Approach
- Consider trauma as part of the differential diagnosis for behavioral, developmental, emotional, and physical health issues 1
- Screen for trauma histories across generations 2
- Recognize that trauma-related difficulties should not be viewed as malicious actions or intentional behaviors 1
Treatment Considerations
- Trauma-informed care (TIC) is essential for identifying and addressing trauma 1
- Early interventions may prevent acute stress reactions from escalating to PTSD 4
- Safe, stable, nurturing relationships are fundamental for developing resilience 1
Understanding trauma and its impacts is critical for healthcare providers to deliver appropriate care that addresses both the psychological and physical consequences of traumatic experiences, while avoiding retraumatization of affected individuals.