From the Guidelines
Full remission of trauma symptoms means that an individual no longer experiences significant symptoms related to their trauma and has returned to their baseline level of functioning, as supported by the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline 1. This typically includes the absence of intrusive memories, flashbacks, nightmares, hypervigilance, avoidance behaviors, and emotional numbing that are characteristic of trauma responses. For someone with PTSD, full remission would mean they no longer meet the diagnostic criteria for the disorder and can engage in daily activities without being significantly impaired by trauma-related symptoms. Some key points to consider include:
- The revised CPG includes 34 recommendations in the following 5 topic areas: assessment and diagnosis, prevention, treatment, treatment of nightmares, and treatment of posttraumatic stress disorder (PTSD) with co-occurring conditions 1.
- Six recommendations on PTSD treatment were rated as strong, including the use of specific manualized psychotherapies over pharmacotherapy; prolonged exposure, cognitive processing therapy, or eye movement desensitization and reprocessing psychotherapy; paroxetine, sertraline, or venlafaxine; and secure video teleconferencing to deliver recommended psychotherapy when that therapy has been validated for use with video teleconferencing or when other options are unavailable 1.
- Treatment approaches that can lead to full remission include trauma-focused psychotherapies like Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE), typically delivered in 12-16 weekly sessions, sometimes combined with medications such as SSRIs (sertraline 50-200mg daily or paroxetine 20-60mg daily) for symptom management 1. Full remission doesn't necessarily mean complete absence of all symptoms or memories of the trauma, but rather that any remaining symptoms are manageable and don't significantly impact quality of life. The brain's natural neuroplasticity allows for trauma processing and integration of these experiences in a way that reduces their emotional intensity and disruptive nature.
From the Research
Definition of Full Remission of Trauma Symptoms
Full remission of trauma symptoms refers to the state where an individual no longer experiences significant symptoms of post-traumatic stress disorder (PTSD) [ 2 ].
Characteristics of Remission
Studies have shown that remission from PTSD can occur in a significant proportion of individuals, with estimated remission rates ranging from 8 to 89% [ 3 ]. The time to remission can vary greatly, with a median time to remission of 14 years reported in one study [ 2 ].
Factors Influencing Remission
Several factors can influence the likelihood and speed of remission, including:
- Type of traumatic event: Individuals who experience childhood trauma, interpersonal violence, or severe symptoms may be less likely to remit from PTSD [ 2 ].
- Co-morbidity: Presence of secondary anxiety or affective disorders can also impact remission [ 2 ].
- Time since trauma: Studies have shown that remission rates may be higher in individuals who are assessed closer to the time of the traumatic event [ 3 ].
Treatment and Remission
While some studies have focused on the effectiveness of various treatments, such as medication and trauma-focused psychotherapy, in reducing PTSD symptoms [ 4 ], others have explored the concept of remission in the context of treatment [ 5 ]. However, the relationship between treatment and full remission of trauma symptoms is complex and requires further research.