Trauma Annotated Bibliography
This annotated bibliography was peer reviewed by ISSTD and represents a thoughtful summary of what are believed to be salient information in the articles noted.
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Topics (in Alphabetical Order)
Acute stress disorder and posttraumatic stress disorder in victims of violent crime
OBJECTIVE: In a group of crime victims recruited from the community, the authors investigated the ability of both a diagnosis of acute stress disorder and its component symptoms to predict posttraumatic stress disorder (PTSD) at 6 months. METHOD: A mixed-sex group of 157 victims of violent assaults were interviewed within 1 month of the crime. At 6-month follow-up 88% were reinterviewed by telephone and completed further assessments generating estimates of the prevalence of PTSD. RESULTS: The rate of acute stress disorder was 19%, and the rate of subsequent PTSD was 20%. Symptom clusters based on the DSM-IV criteria for acute stress disorder were moderately strongly interrelated. All symptom clusters predicted subsequent PTSD, but not as well as an overall diagnosis of acute stress disorder, which correctly classified 83% of the group. Similar predictive power could be achieved by classifying the group according to the presence or absence of at least three reexperiencing or arousal symptoms. Logistic regression indicated that both a diagnosis of acute stress disorder and high levels of reexperiencing or arousal symptoms made independent contributions to predicting PTSD. CONCLUSIONS: This exploratory study provides evidence for the internal coherence of the new acute stress disorder diagnosis and for the symptom thresholds proposed in DSM-IV. As predicted, acute stress disorder was a strong predictor of later PTSD, but similar predictive power may be possible by using simpler criteria.
Acute stress disorder as a predictor of posttraumatic stress symptoms
OBJECTIVE: Using the DSM-IV diagnostic criteria for acute stress disorder, the authors examined whether the acute psychological effects of being a bystander to violence involving mass shootings in an office building predicted later posttraumatic stress symptoms. METHOD: The participants in this study were 36 employees working in an office building where a gunman shot 14 persons (eight fatally). The acute stress symptoms were assessed within 8 days of the event, and posttraumatic stress symptoms of 32 employees were assessed 7 to 10 months later. RESULTS: According to the Stanford Acute Stress Reaction Questionnaire, 12 (33%) of the employees met criteria for the diagnosis of acute stress disorder. Acute stress symptoms were found to be an excellent predictor of the subjects posttraumatic stress symptoms 7-10 months after the traumatic event. CONCLUSIONS: These results suggest not only that being a bystander to violence is highly stressful in the short run, but that acute stress reactions to such an event further predict later posttraumatic stress symptoms.
The effects of Early Relational Trauma on Right Brain Development, Affect Regulation, and Infant Mental Health
Schore, A.N. (2001). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22(1-2): 201-269. [OPEN ACCESS]
A primary interest of the field of infant mental health is in the early conditions that place infants at risk for less than optimal development. The fundamental problem of what constitutes normal and abnormal development is now a focus of developmental psychology, infant psychiatry, and developmental neuroscience. In the 2nd part of this sequential work, the author presents interdisciplinary data to more deeply forge the theoretical links between severe attachment failures, impairments of the early development of the right brains stress coping systems, and maladaptive infant mental health. He comments on topics such as the negative impact of traumatic attachments on brain development and infant mental health, the neurobiology of infant trauma, the neuropsychology of a disorganized/disoriented attachment pattern associated with abuse and neglect, the etiology of dissociation and body-mind psychopathology, the effects of early relational trauma on enduring right hemispheric function, and some implications for models of early intervention. These findings suggest direct connections between traumatic attachment, inefficient right brain regulatory functions, and both maladaptive infant and adult mental health.
Dissociation, Somatization, and Affect Dysregulation: The Complexity of Adaptation to Trauma
van der Kolk, B.A., Pelcovitz, D., Roth, S., Mandel, F.S., MacFarlane, A., & Herman, J.L. (1996). Dissociation, somatization, and affect dysregulation: The complexity of adaptation to trauma. American Journal of Psychiatry, 153(7): 83-93. [OPEN ACCESS]
This study investigated the relationships between exposure to extreme stress, the emergence of PTSD and symptoms of dissociation, somatization and affect dysregulation. The PTSD field trial for the DSM-IV studied 395 traumatized treatment-seeking subjects and 125 non-treatment-seeking subjects who had also been exposed to traumatic experiences. Subjects were assessed by the High Magnitude Stressor Events Structured Interview, the NIMH Diagnostic Interview Schedule PTSD module, the PTSD module of the Structured Clinical Interview of the DSM-III (SCID). Affect dysregulation, dissociation and somatization were measured with the Structured Interview for Disorders of Extreme Stress (SIDES, an instrument designed specifically for the study). In order to examine the correlations between PTSD, somatization, dissociation, and affect dysregulation (or associated features), subjects were divided into two groups: those with and those without lifetime PTSD. Groups were compared for endorsement of associated features. To examine the relationship between current and lifetime PTSD, no PTSD, and the presence/absence of associated features, the authors divided the subjects into 3 groups – those with current PTSD, those with lifetime PTSD but not currently meeting the criteria for it, and those who have never had PTSD. A third division of subjects was made in order to study the effects of age at onset and the nature of the trauma – early-onset interpersonal trauma, late-onset interpersonal trauma, and disaster trauma.
PTSD, dissociation, somatization and affect dysregulation were found to be highly interrelated, tending not to occur in isolation but rather co-occurring in the same person. It appears that co-occurrence is related to their age when the trauma took place and the nature of the event. “The occurrence of pure PTSD is the exception, rather than the rule.” (p. 89). Subjects who were diagnosed with current PTSD endorsed symptoms of dissociation, somatization and affect dysregulation at much higher rate than those who once but no longer met criteria for PTSD. However, these individuals still had much higher levels of endorsement of these associated features than subjects who never met the criteria for PTSD. Interestingly, those who no longer suffered from PSTD still reported suffering from high levels of dissociation, somatization and affect dysregulation. This suggests it is important to inquire about past trauma and make the association between trauma history and current symptomatology. The study also supports results from precious studies that indicate that the age of onset and nature of the traumatic experience affect the “complexity of the clinical outcome.” Those who had experienced abuse at or before 14, ended up with significantly more dissociative problems, trouble managing anger as well as self-destructive and suicidal behaviors as compared with those who were older when the trauma occurred or were victims of a disaster.