What are the Signs and Symptoms of Trauma and Stressor-Related Disorders?
Jamie Marich, Ph.D., LPCC-S, LICDC-CS, RMT, edited by C. E. Zupanick, Psy.D.In the United States, the majority of clinical helping professions (e.g., psychology, psychiatry, counseling, social work, and marriage and family), use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to describe and diagnose mental, emotional, and relational difficulties. The DSM is published by the American Psychiatric Association. The fifth and most recent edition was published in 2013, and is commonly called DSM-5. The DSM may be considered a living document. It constantly evolves and undergoes revisions as new research changes our understanding of mental and emotional disorders. Therefore, it should not be surprising that the newest edition has many such changes.
The DSM uses a classification system that groups individual diagnoses into clusters of similar disorders. Post-traumatic stress disorder (PTSD) was first introduced in 1980 and was included in the group of disorders known as Anxiety Disorders. One of the major changes in the newest edition, (DSM-5, 2013) was the inclusion of a new group of disorders called Trauma and Stressor-Related Disorders. This involved the re-classification and modification of several existing disorders that were previously classified elsewhere in the manual. For example, as mentioned, PTSD was originally classified with Anxiety Disorders. While PTSD and other stressor-related disorders have anxious features associated with those disorders, the re-classification highlights the important role of stress and trauma in the formation and treatment of these disorders. This change in classification reflected a change in our understanding about the impact of unhealed trauma and unmanaged stress on human behavior.
The new chapter of Trauma and Stressor-Related Disorders contains the following diagnoses:
- Reactive Attachment Disorder
- Disinhibited Social Engagement Disorder
- Acute Stress Disorder
- Posttraumatic Stress Disorder
- Adjustment Disorders
- Unclassified and Unspecified Trauma Disorders
As mentioned, diagnoses within each classification share common symptomology. Different configurations of these symptoms form specific diagnoses within that classification. In the next section, we will describe the common signs and symptoms that result from trauma, stress, and adverse life experiences (e.g., abuse). We will also consider how trauma, stress, and adverse life experiences impact other mental health diagnoses such depressive or mood disorders, anxiety disorders, or personality disorders, even though these are separately classified.
It should be noted that the experience of trauma, stress, or abuse does not automatically mean that problems will ensue, or that you will develop a "disorder" of any kind. In the framework of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a disorder generally refers to a cluster of symptoms that interfere with a person's ability to function well in one or more areas of their life (e.g., social or occupational impairment). For instance, the symptoms may make it difficult for someone to form or maintain meaningful social relationships with others (social impairment). In many situations, symptoms may cause problems at school, or may interfere with someone's ability to get and keep a job (occupational impairment). In other words, symptoms alone do not determine the presence of a disorder. For instance, I have a niece who is terrified of the dentist. She has all the symptoms of a phobic disorder, including full-blown panic attacks. However, her dental phobia does not in any way affect her functioning. She still goes to the dentist regularly so her phobic symptoms do not affect her health or other functioning. Thus, she does not meet the criteria for a phobic disorder.
Many people get hung up on the word disorder because it seems to suggest something is inherently wrong with them. If you are one of these people, try not to become overly concerned with the word "disorder," or the words that form diagnostic labels. Clinicians use diagnostic labels as a form of descriptive shorthand that rapidly communicates a set of symptoms. Used outside this context, these labels can take on a meaning that was never intended. Likewise, if the word symptom is too charged for you, you can think of symptoms as challenges that indicate the need for a more adaptive response. Once a more adaptive response is developed and applied, life functioning improves as strength and resilience are revealed.
In this next section we describe the symptoms that characterize the group (or class) of disorders called Trauma and Stressor-Related Disorders. During this discussion, we will highlight the different ways these symptoms manifest in both children and adults. Later we will discuss specific disorders within this class.
What is Complex Trauma?
Resources
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Articles
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Introduction to Trauma and Stressor-Related Disorders
- Introduction to PTSD, Trauma, Abuse and Other Stress-Related Disorders
- What Are Trauma and Stressor-Related Disorders?
- Physical and Emotional Trauma
- How is Trauma Different from Stress?
- What are Adverse Life Experiences?
- Can Grief and Loss Be Traumatic?
- Are Abuse and Neglect Types of Trauma?
- What is Complex Trauma?
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Signs and Symptoms of Trauma and Stressor-Related Disorders
- What are the Signs and Symptoms of Trauma and Stressor-Related Disorders?
- Intrusive Symptoms
- Distressing Images, Thoughts, Memories
- Flashbacks, Dissociative Reactions
- Distressing Dreams and Nightmares
- Intense or Prolonged Psychological Distress
- Physiological Distress or Body Memory
- Intrusive Symptoms: Children's Re-Enactment As Re-Experiencing
- Avoidance Symptoms
- Negative Thoughts and Feelings: The Cognitions and Mood Symptoms
- Arousal and Reactivity Symptoms
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Diagnostic Descriptions of Trauma and Stressor-Related Disorders
- The Trauma and Stressor-Related Disorders: Diagnostic Descriptions
- Post-Traumatic Stress Disorder (PTSD) Criteria
- Acute Stress Disorder Criteria
- Adjustment Disorders Criteria
- Reactive Attachment Disorder & Disinhibited Social Engagement Disorder Criteria
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What Causes the Symptoms of Trauma-Related Disorders?
- What Causes the Symptoms of Trauma-Related Disorders?
- Trauma and the Triune Brain
- Reptilian Brain of Survival and Mammalian Brain
- Trauma and the Neomammalian Brain (Cerebral Cortex)
- Trauma's Physical and Emotional Toll on the Body
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Treatment of Trauma, PTSD, Abuse and Other Stressor-Related Disorders
- The Treatment of Trauma, PTSD, Abuse, and Other Stressor-related Disorders
- Revolutionary New Treatments For PTSD, Trauma, Abuse, and Other Stress-Related Disorders
- The Basic Framework of Trauma Treatment and Recovery
- Finding and Choosing a Trauma Therapist
- Evidence-Based Practices: How Do I Know If a Trauma Treatment Is Effective?
- Traditional Cognitive Therapies
- Hybrid Cognitive Therapies: Mindfulness and Cognitive Therapy
- Exposure and Visualization Therapies
- Eye Movement Desensitization and Reprocessing (EMDR) and Related Approaches
- Body, Movement & Expressive Arts Therapies
- Energy Therapies & Other Innovative Approaches
- Feedback-Informed Treatment
- Medication for Trauma and Stressor-Related Disorders
- Combination Models on the SAMHSA Registry
- A Final Note on Treatment Options
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Conclusion, Resources and References
- Resilience, Resolution, Reconciliation, and Recovery: Some Closing Remarks
- Helpful Websites
- References
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Dealing with the Effects of Trauma - A Self-Help Guide
- Dealing with the Effects of Trauma Introduction
- Help From Health Care Providers, Counselors and Groups
- Things You Can Do Every Day to Help Yourself Feel Better
- The Healing Journey
- Moving Forward on Your Healing Journey
- Further Resources
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Introduction to Trauma and Stressor-Related Disorders
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Book & Media Reviews
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More Information
- An Interview with Pat Bracken, MD, Ph.D. on Post-Modern Psychiatry and the Social Context of Trauma
- Wise Counsel Interview Transcript: An Interview with Edna Foa, Ph.D. on the Nature and Treatment of PTSD
- Wise Counsel Interview Transcript: An Interview with Frank Ochberg, MD on Post-Traumatic Stress Disorder (PTSD)
- Wise Counsel Interview Transcript: An Interview with Victoria Lemle Beckner, Ph.D. on Treatments for Post-Traumatic Stress Disorder (PTSD)
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