Trauma and Stressor-Related Disorders

Comprehensive vocabulary flashcards covering DSM-5 diagnostic criteria, prevalence rates, theoretical models, risk factors, and evidence-based treatments for PTSD, Acute Stress Disorder, Prolonged Grief Disorder, and Adjustment Disorder.

Posttraumatic Stress Disorder (PTSD)

A mental health condition that can develop after experiencing or witnessing a traumatic event, characterised by intrusive memories, heightened arousal, and avoidance of reminders of the trauma.

DSM-5 Trauma Exposure Criterion (PTSD)

Directly experiencing, witnessing in person, learning about through close family or friends, or repeated occupational exposure to actual or threatened death, serious injury, or sexual violence.

Media Exposure Exclusion (PTSD)

Under current DSM-5 guidelines, indirect exposure to trauma through electronic media, television, movies, or social media does not qualify as traumatic exposure for a PTSD diagnosis.

Type of Harm Criterion (PTSD)

A required feature of trauma exposure specifying that the harm involved can be actual or threatened, but must involve a genuine threat to life or physical integrity.

Intrusion Symptoms Cluster (PTSD)

The DSM-5 symptom cluster consisting of recurrent, involuntary, and distressing memories, flashbacks, or trauma-related nightmares directly linked to the event.

Flashbacks

Dissociative intrusions where an individual feels or acts as though the traumatic event is recurring, ranging from brief sensory reliving to a complete loss of awareness of current surroundings.

Trauma-Related Nightmares

Distressing dreams whose content or emotional tone is directly related to the traumatic event, classified under the intrusion symptom cluster of PTSD.

Avoidance Symptoms Cluster (PTSD)

Persistent efforts to avoid distressing memories, thoughts, feelings, or external reminders (such as people, places, conversations, or activities) associated with the trauma.

Internal vs. External Avoidance in PTSD

Internal avoidance involves suppressing trauma-related thoughts and emotions, whereas external avoidance involves staying away from people, places, or conversations that trigger trauma memories.

Negative Alterations in Cognition and Mood Cluster (PTSD)

Persistent negative beliefs about oneself, others, or the world, distorted blame, persistent negative emotional states, diminished interest, detachment, or an inability to experience positive emotions.

Arousal and Reactivity Changes Cluster (PTSD)

Trauma-related neurobiological alterations manifesting as irritability, angry outbursts, reckless or self-destructive behaviour, hypervigilance, exaggerated startle response, concentration difficulties, or sleep disturbances.

Hypervigilance

A state of heightened alertness and constant scanning of the environment for potential threats or danger, classified within the arousal and reactivity cluster of PTSD.

Exaggerated Startle Response

An abnormally intense physiological or behavioral reaction to unexpected stimuli, serving as a diagnostic symptom within the arousal and reactivity cluster of PTSD.

Duration and Impairment Criterion (PTSD)

The diagnostic requirement that PTSD symptoms must persist for at least $1\text{ month}$ and cause clinically significant distress or functional impairment.

Lifetime Prevalence of PTSD

Estimated to be approximately $7\%$ across the general population, with epidemiological ranges spanning between $3\%$ and $27\%$.

Past-Year Prevalence of PTSD

Estimated to be approximately $4\%$ in a given year, with reported study ranges spanning between $8\%$ and $57\%$.

Post-Trauma PTSD Prevalence Rate (Schincariol et al., 2024)

An umbrella review finding demonstrating that approximately $24\%$ of individuals report developing PTSD following exposure to a traumatic event.

Gender Disparity in PTSD (Tolin & Foa, 2006; Olff, 2017)

Epidemiological evidence showing that women are $2\text{--}3$ times more likely than men to develop PTSD following trauma exposure.

Cognitive Model of Persistent PTSD Diagram (Ehlers and Clark, 2000)

A diagram illustrating how trauma characteristics, prior beliefs, cognitive processing during trauma, fragmented trauma memory, negative appraisals, and threat-control strategies interact to produce a persistent sense of current threat.

Occupational PTSD Risk (Arena et al., 2025)

Research documenting heightened risk among first responders, police, military, and emergency medical personnel, with some studies showing $1\text{ in }7$ developing PTSD during routine duties.

Interpersonal vs. Non-Interpersonal Trauma (Kessler et al., 2017)

Findings indicating that human-caused interpersonal violence (e.g., rape, domestic violence, assault) is more likely to lead to PTSD than natural disasters (e.g., floods, earthquakes).

Subthreshold PTSD

A condition in which individuals experience significant post-trauma distress and functional impairment without fulfilling the complete diagnostic criteria for PTSD, associated with elevated risk for depression, substance use, and suicidality.

Ehlers and Clark's Cognitive Model (2000)

An influential cognitive model positing that persistent PTSD occurs when individuals appraise trauma and its sequelae in a way that generates a sense of serious current threat, driven by poorly integrated trauma memories and maladaptive beliefs.

Fragmented Trauma Memories

Poorly integrated, sensory-rich trauma memories formed because the brain prioritises survival over chronological encoding during a trauma, causing them to lack temporal context and trigger re-experiencing.

Disorganised Trauma Narratives

Trauma narratives lacking a clear timeline (beginning, middle, end) or logical sequence, which empirical studies correlate with higher PTSD symptom severity and ongoing distress.

Perceived Ongoing Threat

A cognitive mechanism in PTSD wherein an individual feels danger is continuously present due to unprocessed memories and negative appraisals, fueling hypervigilance and avoidance.

Autobiographical Memory Disruption (PTSD)

A cognitive disturbance wherein trauma memories are not situated within an individual's personal past, maintaining distress until therapeutic processing integrates them into general autobiographical memory.

Genetic Heritability of PTSD (Almli et al., 2014)

Research estimating that genetic factors account for approximately $30\text{--}40\%$ of the heritability of vulnerability to developing PTSD.

Neurobiological Regions in PTSD

Key brain structures exhibiting functional and structural alterations in PTSD, specifically the amygdala (fear processing), hippocampus (memory integration), and prefrontal cortex (executive control).

Altered Cortisol in PTSD (Wessa et al., 2006)

Documented biological alterations in the hypothalamic-pituitary-adrenal (HPA) axis, resulting in abnormal baseline stress hormone levels in individuals diagnosed with PTSD.

Clinician-Administered PTSD Scale (CAPS)

A structured clinical interview recognized as the gold standard assessment instrument for diagnosing PTSD and evaluating symptom frequency and severity.

PTSD Symptoms Scale - Interview (PSS-I)

A clinician-administered interview tool specifically designed to evaluate the presence and severity of PTSD symptoms according to DSM diagnostic criteria.

Life Events Checklist (LEC)

A standardized self-report instrument used to screen for lifetime exposure to potentially traumatic events across a person's life history.

PTSD Checklist (PCL)

A widely utilized self-report screening questionnaire used to evaluate PTSD symptoms and monitor clinical change over the course of treatment.

Psychological First Aid (PFA)

An evidence-based immediate post-trauma intervention focusing on ensuring physical safety, calming, meeting practical needs, and connecting survivors to social support without forcing trauma discussion.

Critical Incident Stress Debriefing (CISD)

A contraindicated early intervention involving mandatory immediate group emotional processing of trauma, which research shows can increase distress and elevate PTSD risk.

Trauma-Focused Therapies

Recommended psychological interventions for established PTSD, including Prolonged Exposure, Cognitive Processing Therapy, and Cognitive Behavioural Therapy, incorporating psychoeducation, exposure, and cognitive restructuring.

Eye Movement Desensitization and Reprocessing (EMDR)

A psychotherapeutic approach involving the recall of traumatic memories while focusing on bilateral sensory stimuli (e.g., finger movements), designed to lower emotional intensity while maintaining present awareness.

Efficacy of EMDR (Wright et al., 2024)

An individual patient data meta-analysis demonstrating that EMDR is as effective as other evidence-based trauma treatments in reducing PTSD symptom severity.

Acute Stress Disorder (ASD)

A psychiatric condition developing in the acute aftermath of trauma, designed to capture severe immediate stress reactions occurring from $3\text{ days}$ to $4\text{ weeks}$ post-event.

Trauma Exposure Criterion for ASD

Exposure to actual or threatened death, serious injury, or sexual violation through direct experience, witnessing in person, learning about a close other, or repeated occupational duties.

Five Symptom Clusters of ASD

The diagnostic categories defined in the DSM-5 for ASD: intrusion, negative mood, dissociation, avoidance, and arousal.

Symptom Threshold for ASD

The DSM-5 diagnostic requirement that an individual must present with at least $9$ symptoms selected from any combination across the five recognized symptom clusters.

Duration of Symptoms for ASD

The temporal diagnostic requirement specifying that symptoms must persist for at least $3\text{ days}$ and no longer than $4\text{ weeks}$ following trauma exposure.

Intrusion Symptoms in ASD

Unwanted, recurrent, and distressing trauma-related memories, dreams, or dissociative flashbacks emerging within $4\text{ weeks}$ of the traumatic event.

Negative Mood in ASD

A persistent inability to experience positive emotions (such as happiness, joy, or satisfaction), creating feelings of detachment or emotional numbness in the acute trauma phase.

Dissociative Symptoms in ASD

Acute trauma responses including feeling dazed, altered perceptions of time, dreamlike states, detachment from self or surroundings, or dissociative amnesia for trauma details.

Avoidance Symptoms in ASD

Conscious efforts to steer clear of distressing memories, thoughts, feelings, conversations, people, or places that prompt recall of the traumatic incident.

Arousal Symptoms in ASD

Heightened physiological stress reactions in the acute phase, including sleep disturbances, irritability, difficulty concentrating, hypervigilance, and exaggerated startle responses.

Clinical Significance Criterion in ASD

The diagnostic requirement that symptoms must cause significant distress or functional impairment and cannot be due to substance physiological effects, a medical condition, or another disorder.

Symptom Structure Differences: ASD vs. PTSD

ASD requires any combination of at least $9$ symptoms from $5$ clusters, whereas PTSD requires a fixed distribution of symptoms across $4$ specific clusters.

Diagnostic Timing Differences: ASD vs. PTSD

ASD is diagnosed strictly between $3\text{ days}$ and $4\text{ weeks}$ after trauma; PTSD cannot be diagnosed until symptoms have persisted for more than $1\text{ month}$.

Prognostic Intent of ASD

A clinical framework designed to identify individuals experiencing severe acute maladaptive reactions who are at high risk of progressing to chronic PTSD, facilitating early intervention.

Overpathologizing Debate in ASD

The clinical and academic debate questioning whether diagnosing ASD inappropriately medicalizes transient, normal human stress reactions during the immediate post-trauma period.

Trauma Proximity and ASD Risk

A recognized risk factor where being physically close to or directly in the center of a life-threatening traumatic event increases the likelihood of developing ASD.

Prior Trauma History in ASD

An established individual vulnerability factor wherein prior exposure to traumatic events significantly amplifies the risk of developing ASD after a new trauma.

High-Risk Occupations for ASD

Vocations characterized by regular or repeated exposure to critical incidents (e.g., firefighters, paramedics, military personnel, police) that elevate vulnerability to ASD.

Initial Shock Phase of Trauma (Days 1–3)

The early post-trauma interval typically characterized by acute shock, confusion, and distress, during which symptoms are expected and ASD cannot yet be diagnosed.

Acute Symptom Phase of ASD (Days 3–30)

The temporal period following trauma when intrusive, dissociative, avoidant, and hyperarousal symptoms emerge, fluctuate in severity, and fulfill the criteria for an ASD diagnosis.

Fourth-Week Resolution or Progression

The clinical transition point at the end of $4\text{ weeks}$ where ASD either resolves spontaneously or, if symptoms continue beyond $1\text{ month}$, shifts to a PTSD diagnosis.

CAPS Acute Stress Disorder Module

A specialized clinician-administered structured interview tool used to evaluate the diagnostic criteria and severity of Acute Stress Disorder.

Timing of Trauma-Focused CBT in ASD

Clinical guideline recommending that trauma-focused psychological therapy be introduced after the acute initial days if severe symptoms fail to resolve, preventing PTSD development.

Prolonged Grief Disorder (PGD)

A DSM-5 diagnosed condition characterized by an intense, persistent, and disabling grief response following the death of a loved one that outlasts cultural and societal expectations.

Time Since Loss Criterion for Adults (PGD)

The DSM-5 diagnostic requirement specifying that at least $12\text{ months}$ must have elapsed since the death of a loved one before diagnosing PGD in an adult.

Time Since Loss Criterion for Children and Adolescents (PGD)

The DSM-5 diagnostic requirement specifying that at least $6\text{ months}$ must have elapsed since the death before diagnosing PGD in a child or adolescent.

Pervasive Grief Criterion (PGD)

The requirement that an individual must experience severe grief symptoms on most days for at least $1\text{ month}$ beyond the required post-loss timeframe.

Symptom Threshold for PGD

The DSM-5 diagnostic requirement that the bereaved person must present with at least $3$ specific symptoms from the recognized prolonged grief symptom cluster.

Identity Disruption (PGD)

A core diagnostic symptom of PGD involving a profound feeling that part of oneself has died, or feeling unable to identify who one is without the deceased.

Disbelief Regarding the Death (PGD)

A persistent diagnostic symptom characterized by marked difficulty accepting the reality, permanence, and finality of the loved one's passing.

Intense Emotional Pain (PGD)

Persistent and debilitating feelings of sorrow, emotional yearning, anger, bitterness, or profound guilt experienced regularly in response to the bereavement.

Difficulty Reintegrating (PGD)

A symptom of PGD characterized by notable impairment in engaging with friends, pursuing meaningful activities, maintaining work roles, or planning for future life.

Emotional Numbness in PGD

The pervasive absence of emotional feeling, marked detachment from others, and an inability to experience positive or affectionate emotions following bereavement.

Feeling of Meaninglessness (PGD)

A persistent subjective state in which life feels completely empty, purposeless, or futile following the death of a significant attachment figure.

Prevalence of Prolonged Grief Disorder

Epidemiological studies indicate that PGD occurs in approximately $1\text{--}15\%$ of bereaved individuals, depending on assessment methodology and population characteristics.

High-Risk Kinship Relationships in PGD

Bereavement involving the death of a child or spouse, which empirical evidence identifies as having the highest risk for the development of Prolonged Grief Disorder.

Nature of Death and PGD Risk

Sudden, unexpected, or violent modes of death (such as suicide, homicide, or fatal accidents) that significantly increase PGD vulnerability relative to anticipated natural deaths.

Dual Process Model of Bereavement

A theoretical model conceptualizing normal coping with bereavement as an adaptive oscillation between loss-oriented coping and restoration-oriented coping.

Cognitive-Behavioural Model of PGD (Boelen et al., 2006)

A model proposing that PGD is maintained by poor integration of the loss into autobiographical memory, maladaptive beliefs about the self and world, and anxious/depressive avoidance.

Attachment and Meaning-Making Models (Maccullum & Bryant, 2013)

Theoretical frameworks attributing prolonged grief to the severe rupture of attachment bonds and an inability to reconstruct meaningful interpretations of life after loss.

Inventory of Complicated Grief (ICG)

A standardized self-report assessment questionnaire designed specifically to measure the presence and severity of complicated or prolonged grief symptoms.

PG-13 Assessment Tool

A $13\text{-item}$ self-report diagnostic instrument designed to evaluate cognitive, emotional, and behavioural symptoms of Prolonged Grief Disorder.

Structured Clinical Interview for Complicated Grief

A $31\text{-item}$ clinician-administered diagnostic interview that assesses grief-related symptoms experienced over the past month to determine a PGD diagnosis.

Cognitive-Behavioural Therapy for Grief

The primary evidence-based psychotherapy for PGD, utilizing cognitive restructuring of unhelpful beliefs, gradual reduction of avoidance, and behavioural activation.

Adjustment Disorder

A DSM-5 stressor-related disorder characterized by emotional or behavioral symptoms emerging in response to an identifiable life stressor that cause disproportionate distress or impairment.

Identifiable Stressor Criterion (Adjustment Disorder)

The diagnostic requirement that emotional or behavioural symptoms must begin within $3\text{ months}$ of the onset of a recognizable, identifiable life stressor.

Everyday Stressors in Adjustment Disorder

Common life events (e.g., relationship breakups, divorce, job loss, financial stress, academic failure, relocation) that do not require an immediate life threat to trigger a disorder.

Disproportionality Criterion (Adjustment Disorder)

The requirement that the individual's distress must be out of proportion to the severity or intensity of the stressor, considering the cultural context and external support factors.

Functional Impairment in Adjustment Disorder

Noticeable difficulties in daily life, work, academic performance, or interpersonal relationships directly caused by emotional or behavioural responses to a stressor.

Diagnostic Exclusion Criteria for Adjustment Disorder

The rule stating that symptoms must not meet criteria for another mental disorder (such as MDD) and must not represent an exacerbation of a preexisting condition.

Duration and Remission Course (Adjustment Disorder)

The clinical standard wherein symptoms typically resolve within $6\text{ months}$ after the stressor or its immediate consequences have terminated.

Persistent (Chronic) Adjustment Disorder

A presentation of adjustment disorder that endures beyond $6\text{ months}$ because the underlying stressor or its consequences are ongoing, prolonged, or recurring.

Emotional Presentations of Adjustment Disorder

Symptom manifestations characterized primarily by persistent depressed mood, tearfulness, feelings of hopelessness, nervousness, worry, or anxiety following a stressor.

Behavioral Presentations of Adjustment Disorder

Symptom patterns presenting with conduct changes, social withdrawal, neglect of responsibilities, irritability, reckless actions, or altered routines after a stressor.

Child and Adolescent Presentation of Adjustment Disorder

Developmental variations where adjustment reactions predominantly present as behavioral disruption, school difficulties, acting out, or peer conflict.

Older Adult Presentation of Adjustment Disorder

Late-life symptom presentations frequently triggered by transitions such as retirement, physical health problems, functional decline, or non-pathological bereavement.

Protective Factors Against Adjustment Disorder

Psychosocial buffers that foster resilience against maladaptive stress reactions, specifically strong social support, effective coping mechanisms, and cognitive flexibility.

Differential Diagnosis: Adjustment Disorder vs. Major Depressive Disorder

Adjustment disorder requires an identifiable stressor within $3\text{ months}$ and subthreshold distress; MDD requires at least $2\text{ weeks}$ of persistent low mood and can emerge without a clear trigger.

Differential Diagnosis: Adjustment Disorder vs. PTSD

PTSD requires exposure to actual/threatened death, serious injury, or sexual violence plus intrusion/flashbacks; adjustment disorder can follow non-traumatic everyday events and lacks full PTSD clusters.

Assessment of Adjustment Disorder

A clinical diagnostic process using direct interviews, psychosocial history, stressor timeline evaluation, and systematic exclusion of major mood or anxiety disorders.

Psychoeducation and Validation in Adjustment Disorder

An initial treatment component providing education about the normalcy of stress responses, destigmatizing emotional reactions, and fostering hope for timely recovery.