Despite substantial theoretical and empirical advances in the field of traumatic stress since the introduction of the diagnosis of posttraumatic stress disorder (PTSD) into the mental health nomenclature, existing conceptualizations of traumatic stress retain the assumption that traumatic experiences have occurred in the past. We propose continuous traumatic stress (CTS) as a supplementary construct within the lexicon of traumatic stress, to describe the experience and impact of living in contexts of realistic current and ongoing danger, such as protracted political or civil conflict or pervasive community violence. We discuss four key characteristics of CTS and consider these in relation to existing formulations of complicated traumatic stress: the context of the stressor conditions, the temporal location of the stressor conditions, the complexity of discriminating between real and perceived or imagined threat, and the absence of external protective systems. We advance a tentative descriptive picture of how CTS may present and discuss the potential adaptive and pathological dimensions of the phenomenon.

International literature on crime and violence suggests that social cohesion may play a key role in facilitating prevention at community level. It is argued that in South Africa high levels of crime entailing interpersonal violation not only reflect ruptures in the social fabric but also contribute to social disorganization. In exploring the traumatic impact of exposure to fairly pervasive criminality via the constructs of Fear of Crime (FoC) and Continuous Traumatic Stress the article explores some of the linkages between responses to crime and the facilitation or erosion of potentialities for social cohesion. It is argued that the common responses of fearfulness, suspicion and social withdrawal (as well as defensive aggression in some instances) are counter-productive to attempts to build pro-social organization. Consequently a rather intractable circular relationship may ensue in which the conditions that enable criminality are not challenged because indirect and direct exposure to violation, alongside perceived and actual deficits in formal state interventions, have eroded the motivation and capacity of citizens to tackle such conditions, leaving spaces open for violation to continue unchecked, Some of the complexities of thinking about forms of social cohesion as a route to challenge crime and its impact in South Africa are elaborated. It is emphasized that collective efficacy appears to be the aspect of social cohesion that is most pivotal in addressing this feature of society.

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In the last 6 decades, large sections of the global population have been exposed to ongoing dangers in circumstances of pervasive conflict, violence and trauma. In this article, we revisit the concept of continuous traumatic stress, originally proposed by South African researcher-practitioners to characterize mental health conditions and challenges under apartheid, and explore its viability as an alternative and supplementary framework for understanding and addressing exposure to situations of ongoing threat. The article highlights the political and mental health limitations associated with the dominance of posttraumatic stress conceptualizations of these forms of human suffering and distress, and calls for more nuanced and complex understandings of such complicated psychosocial conditions and their effects. It concludes by foregrounding several critical debates related to continuous traumatic stress, namely, the importance of understanding contexts of ongoing exposure to danger as both political and psychological (psychopolitical) in nature; of developing socially relevant clinical and conceptual models that can meaningfully account for the varied impacts of, and responses to, these conditions of continuous threat; and the need to extend our intervention practices to include culturally and contextually appropriate intervention strategies that are both clinical and psychosocial in orientation.

This article discusses the condition of continuous traumatic stress as common on the African continent and in other international settings characterised by very high levels of ongoing violence and threat of community, political or war-related origin. Through consideration of three case studies from South Africa, contexts of continuous traumatic stress are described, and the mental health and physical health effects of living in such contexts are elaborated. Cautions are raised about attempting to transpose existing posttraumatic stress models onto individuals exposed to situations of continuous traumatic stress, and guidelines for optimal interventions with such cases are proposed.