This chapter reviews the psycho-social aspects of trauma and related disorders. A wealth of information has accumulated over the decades of research on the trauma and related disorders. However, some aspects of trauma are still debatable globally such as definition of trauma, diversity in expression and response across individuals and cultures. Exposure to trauma can lead to troubling memories, psycho-physical arousal and avoidance of the event, has been a central theme in literature. Until researchers have realized the complexity of trauma transcends the relatively narrow definition of trauma. Cultural diversity in trauma and related disorders have brought into notice the multi-dimensional nature of trauma which is the focus of this chapter.
TopIntroduction
The debate and concern over the existence of Post-traumatic stress disorder (PTSD) started soon, after its inception in the diagnostic manual of American psychiatric association in 1980’s (Breslau, 2004; Summerfield, 1995; Young, 2004). While mostly research directly or indirectly accepts its existence as a disorder. However, studies question the universalization and conceptualization of post traumatic disorder using biomedical model of trauma without considering the socio-political context (Bracken, Giller & Summerfield, 1995; Kleinman, 1988; Summerfield, 1999; Miro Jakovljević, et al., 2012; Van Ommeren, Saxena & Saraceno, 2005). There have been concerns and debates regarding understanding of trauma in the current scenario from its operationalization to intervention but the major ones can be summarized as follows (Bracken, Giller & Summerfield, 1995; Breslau, 2004 Kleinman, 1988; Summerfield, 1999; Miro Jakovljević, et al., 2012; Van Ommeren, Saxena & Saraceno, 2005).
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Universalization of Post-traumatic stress disorder.
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Biomedical model and social model of understanding Post-traumatic stress disorder.
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Psychological, social, moral and political aspects of trauma.
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Appropriateness of a trauma based intervention cross-culturally.
Top1. Universalization Of Post-Traumatic Stress Disorder
Traumatology has two meanings, depends on the definition of trauma. In medicine, it refers to the study of wounds and injuries caused by accidents or violence to a person. In psychology, it refers to the development and application of psychological services for people who have experienced extreme events. The focus of this chapter is the psychological aspects of trauma. The universalization of Post-traumatic stress disorder (PTSD) diagnosis remains controversial from decades due to many psycho-socio-political reasons (Bracken, Giller & Summerfield, 1995; Kleinman, 1988; Summerfield, 1999; Miro Jakovljević, et al., 2012; Van Ommeren, Saxena & Saraceno, 2005). Symptoms suggestive of Post-traumatic stress disorder (PTSD) have been noted following any significant catastrophe over the centuries in the research literature (Young, 1995, 2004). However the actual terms Post-traumatic stress disorder (PTSD) did not appear until 1980 (Young, 2004). In the 19th century, an attempt was made to categorize psychological disorders, in which the term “fright neurosis” was used to capture anxiety symptoms following any significant accident and injury (Kraepelin, 1896). Exposure to overwhelming terror can lead to troubling memories, arousal, and avoidance but with a varied manifestation and underlying dynamics. With time, various diagnostic systems came into existence which are used in different parts of the world. Among these diagnostic systems, Diagnostic and Statistical Manual of Mental Disorders (DSM) by American Psychiatric Association and the International Classification of Disorders (ICD) by World Health Organisation are widely used. The latest version of diagnostic manual of American Psychiatric Association has some changes in diagnostic criteria of trauma and other psychiatric disorders. The World Health Organisation is going to revise it manual in its next edition of ICD-10.