Trauma and resilience

Trauma

event or series of events that involve fear or threat

Traunatisation

when both internal and external resources are inadequate to cope with threat.

causes and nature of trauma

happens when experiencing or witnessing:

• abuse

• neglect

• accident

• natural disaster

• conflict, war, genocide

can be a single event, recurring, complex (prolonged multiple) or intergenerational

Acute Stress Disorder

a brief period of intrusive recollections occuring within 4 weeks f witnessing or experiencing an overwhelming traumatic event

• =or>9 symptoms for 3 days - 1 month

• must cause impairment and dysfunction not by substance or other disorder

Post traumatic stress disorder

recurring intrusive recollections of an overwhelming traumatic event, >1 month within the 6 months of event

PTSD prevelance

• 3% of population

• lifetime prevalance 1.9-8.8%

PTSD and co-occuring conditions

Variable reactions to trauma

Post traumatic growth PTG

positive change experienced from struggled with major stress, typically trauma

• greater appreciation of life

• improved relationships

• changed priorities

• changed self/personal strength

• spiritual growth

reactions to trauma

PTG in response to trauma is common 30-80%

PTG does not mean no symptoms of stress/trauma

• resilience vs growth

  • resilience = ability to recover, adjust to adversity

  • growth = a new level of functioning and way of being

Biological approach: Physiology memory (explain symptoms not the cause)

• negative stress reactions are due to physiology, more likely in those:

  • increased adrenaline

  • elevated blood pressure during certain stimuli

  • elevated cortisol

• negative stress reactions are due to faulty memory/limbic systems, affecting retrievability of info:

  • heightened amygdala responding

  • hippocampal atrophy

Cognitive and behavioural models

learning model: trauma symptoms are learned responses - sounds, smells & objects trigger memories → cond response

cognitive model: dysfunctional information processing treatment

• educate

• target trauma thoughts/emotions

• develop adaptive appraisals

• manage anxiety

social identity approach

1. Social identity is central to the experience and appraisal of trauma

• Trauma has group-based dimensions - experience as a consequence of group membership eg soilder in war

• Individual trauma is more common in particular eg minority groups

social identity approach - intergenerational trauma

• creation of indian residential schools 1863-1996

• aim to eliminate indians

• forced assimilation

• shamed culture, language and physical, sexual & emotional abuse

Results intergenerational trauma

• to the extent that indigenous heritage more central to identity, then

  • more likely to be exposed to discrimination

  • feels the effects of discrimination and abuse more strongly

  • experience greater psychological distress and trauma reactions

social identity approach: resilience and growth

resilience and growth is more likely when an emergent sense of common fate and collective identity develops

resilience and growth following trauma - earthquake

social identity approach: as a process for change

trauma as a process of social identity change

The social identity model of traumatic identity change SIMTIC

Social identity revitalization

qualitative change in the meaning, purpose & value of emergent group memberships and identities post-trauma

identity revitalisation