Developments in Psychotraumatology: A Conceptual, Biological, and Cultural Update

Abstract

This report discusses recent developments of psychotraumatology mainly related to the recently published ICD-11, but also from a societal point of view.The selected aspects of the development of this field will be presented as a scoping review.In the first section, the new concept of disorders specifically associated with stress and its relevant diagnostic groups (posttraumatic stress disorder [PTSD], complex PTSD, prolonged grief disorder, and adjustment disorder) are presented, with an emphasis on PTSD. The second section embeds these diagnostic concepts within a broader context. In particular, the concept of psychotraumatology is applied to the impact of adverse childhood experiences. More specifically, recent scientific developments are discussed with respect to biological stress research. In a third section, a global perspective is applied that reflects psychotraumatology as embedded in culturally-specific concepts. Lastly, societal developments are taken into consideration. This section focusses on recent processes of victim acknowledgement and compensation taking place in Europe and beyond. Examples are provided for how traumatic stress is perceived and processed in society. Concepts such as continuous stress and historical trauma are also discussed.Demands and opportunities of basic research and psychological interventions with a global focus are outlined.Psychotraumatology is an expanding field including both basic research and intervention-related research.Starting points of this new research area are not only potential traumatic events but also adverse childhood experiences.In a globalized world, cultural and societal factors play an increasingly important role in psychotraumatology.Psychotraumatology is an expanding field including both basic research and intervention-related research.Starting points of this new research area are not only potential traumatic events but also adverse childhood experiences.In a globalized world, cultural and societal factors play an increasingly important role in psychotraumatology.

Lay causal beliefs about PTSD and cultural correlates in five countries

“…Interestingly, differences in causal beliefs were also found between countries that might be perceived as having much in common because they are geographically close and have a common language, such as Mexico and Ecuador, or because they are part of a political union that cooperates on mental health policies, such as Germany and Greece. This is important, as it indicates that the often-used East–West dichotomy is outdated and has little predictive value and that, on the contrary, grouping countries on selective parameters may even be misleading in this way (Maercker, 2019 ). Second, gender and class membership were found to be significantly related, with males being more likely to be in the multiple causes class.…”

“…However, many studies are implicitly or explicitly based on the assumption that participants can be grouped into ‘Western’ and ‘non-Western’, and that the study’s results can be extended to other countries according to this dichotomy. This can be problematic as it does not take into consideration the huge differences that can be found among these broad groups (Maercker, 2019 ). In response, contemporary cultural psychiatry has been moving towards a perspective that accounts for the dynamics of individuals’ hybrid identities, which are in constant transaction and transformation (Good, Willen, Hannah, Vickery, & Park, 2011 ).…”

A new approach to cultural scripts of trauma sequelae assessment: The sample case of Switzerland

“…Studies have confirmed that there is an association between posttraumatic symptom presentations and value orientations [ 29 , 30 ]. Importantly, cultural differences in terms of shared beliefs, value orientations, and norms also exist between Western countries [ 31 – 33 ].…”

Effects of cumulative trauma load on long-term trajectories of life satisfaction and health in a population-based study

“…In the mid-90s, the so-called adverse childhood experiences (ACE) study was the first large investigation on stressful and critical life events during childhood and revealed detrimental long-term effects towards later life such as somatic complaints or mental health disturbances [ 7 , 8 ]. Whilst this initial conceptualization of ACE extends beyond the diagnostic definition of trauma and thus incorporates a broader range of not necessarily traumatic events such as parental absence due to divorce (c.f [ 9 ]. ), the ACE study has launched the systematic investigation of long-term effects of adverse experiences.…”