Disorders related to trauma and stress factors They are a relatively recent category in the DSM that refer to disorders, traditionally belonging to anxiety disorders, caused by traumatic events.
Among these disorders we have some that are well known, such as PTSD, and others associated with dysfunctional attachment or personality traits.
Below we will see in more detail this category with such a long title, in addition to its history and what disorders make it up.
Disorders related to trauma and stress factors: characteristics
Disorders related to trauma and stress factors are a set of mental disorders in which Exposure to a traumatic or very stressful event is one of its main diagnostic criteria
Currently, a stressor is understood as any stressor that disturbs the normal physiological, cognitive, behavioral or emotional balance of a person. The origin of this stressor can be of a different nature, being physical, economic, social or psychological.
For its part, a traumatic factor is any event that can cause serious damage to the physical and psychological integrity of the person whether in the form of a threat of death, serious harm, sexual violence, both to that same person and to a family member or close friend.
Disorders in this category produce a high personal, economic and social cost. On a personal level, they cause discomfort, suffering and a series of post-traumatic consequences so serious that they can leave a person marked for life. In terms of economics, disorders related to trauma and stress factors entail large expenses for state institutions and companies, given that those who suffer from them request long-term sick leave and disability pensions.
From a social point of view, disorders in this category have raised great concern. This has been especially the case in the Western world in the last two decades following such historically traumatic events as 9/11, 3/11 and other attacks, both Islamist and separatist paramilitary groups (e.g. e.g., ETA, IRA and pro-Russian Crimean militias).
This is why developed countries, especially Western Europe and the United States, have designed and implemented programs to reduce the incidence of these disorders and alleviate its consequences.
History
Since the publication of the fifth edition of the DSM (2013), disorders related to trauma and stress factors have their own specific section, being formally separated from anxiety disorders, and establishing themselves as one of the large groups of psychiatric disorders..
As for the other major classification system for mental disorders, these disorders already enjoyed their own separate group since the ICD-10 was published in 1992, only here they are called severe stress reactions and adjustment disorders.
They can also be found, in part, in the personality disorders section of the same ICD-10. There the existence of the calls is recognized persistent personality transformations after catastrophic experience (TPP), in which the consequences of a traumatic event are so devastating that they even manifest decades after being exposed to the traumatic event. To be diagnosed, the event must have been so extreme that personal vulnerability is not required to explain the profound effect on personality.
Main disorders of this category
Next we are going to see the main disorders that make up the category of disorders related to trauma and stress factors.
1. Reactive Attachment Disorder (RAD)
Reactive attachment disorder (RAD) emerges at approximately age 5, with the main feature being a distorted and not properly developed ability to relate socially in most contexts.
Among the general characteristics that we can find in this disorder, we have poor social or emotional reactions towards others, very limited expressions of positive affects and episodes of irritability, sadness or fear without apparent cause or reason.
Children who manifest stress disorder have been victims of some extreme pattern of insufficient care at some point in their lives. Whether due to negligence or social lack, have not had their basic emotional needs met preventing the child from growing up feeling safe.
Disinhibited social relationship disorder also manifests itself in children. The little one shows indiscriminate sociability or lack of selectivity in choosing figures with whom they stick.
Children with this disorder show overly familiar verbal or physical behavior with people who are not part of their close circle, in addition to seeking emotional contact with strangers. For example, they appear excessively familiar with strangers, to whom they ask for things and show affection.
The curious thing is that they turn little or nothing to their usual adult caregiver, that is, their own mother, father or guardian in charge of their care.
This disorder could be considered the disinhibited version of reactive attachment disorder, having a similar origin in its occurrence. Children who express this have not been able to develop a type of secure attachment during their early childhood, which is why they develop different strategies to be able to face different deficiencies or threatening situations.
3. Post-Traumatic Stress Disorder (PTSD)
One of the most prominent trauma-related disorders, Post-Traumatic Stress Disorder (PTSD), manifests itself quite frequently in the population, encountering a prevalence of between 1 and 3.5% in the world
This disorder is especially high among military personnel and other people whose profession involves a high risk of exposure to traumatic events, such as police officers, emergency medical personnel and firefighters, as well as victims of or witnessing terrorist attacks, sexual violence and natural disasters..
PTSD is associated with high rates of social, occupational and physical difficulties as well as high economic costs and increased use of medical services.
Among what causes this disorder, the most notable are:
4. Acute stress disorder
This disorder is characterized by the appearance of a set of anxiety symptoms that occur after being exposed to a highly traumatic event
These alterations last more than two days, up to a maximum of four weeks, and appear the first month after experiencing the traumatic event. If these four weeks are exceeded, a diagnosis of PTSD or adjustment disorder would be considered.
The most common symptoms of this disorder are similar to those of PTSD:
One of the differences with respect to PTSD is that acute stress disorder has early onset that is, it begins to be felt shortly after having been exposed to the traumatic event.
5. Adjustment disorder
Adjustment disorder is a symptomatic manifestation resulting from a clear and defined stressful event lasting three months after its occurrence, but which cannot be classified as PTSD.
For it to be diagnosed, there must have been extremely high discomfort, very disproportionate to what would be expected how a person without the disorder would react to the same stressful event, and which implies a deterioration in the work and social area.
There are several subtypes, including adjustment disorder with:
Whatever the modality, This disorder involves all kinds of problems such as relationship and family problems, sexual dysfunction, financial difficulties, poor academic performance, health problems and job changes.
6. Other specified and unspecified trauma and stressor-related disorder
This category is used to refer to disorders in which characteristic symptoms of disorders related to trauma and stress factors predominate, causing clinically significant discomfort as well as social, occupational and economic deterioration, but which do not meet sufficient diagnostic criteria 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 Related Problems, Tenth Revision (ICD-10). Geneva, Switzerland.
