Trauma Exposure in Posttraumatic Stress and Acute Stress Disorders

Abstract

This chapter reviews the literature on the association between traumatic stress exposure and rates of both posttraumatic stress disorder (PTSD) and acute stress disorder (ASD) among children and adults. It begins by reviewing current definitions of PTSD and ASD, which vary substantially across diagnostic systems. The chapter highlights research linking large-scale events, such as natural disasters and acts of terrorism, with the emergence of PTSD and ASD, as well as the literature on the impact of individual traumatic events, such as sexual assault, child sexual abuse, and medical trauma. The chapter concludes by noting several important directions for future research in the area of trauma exposure and traumatic stress.

Structured Trauma-Related Experiences and Symptoms Screener for Adults (STRESS-A): Validation in a child welfare sample of mothers and fathers with active domestic violence.

“…Reports on trauma exposure, including both Criterion A and non-Criterion A events, suggest that the current sample may serve as a suitable population for evaluating the performance of the STRESS-A. Over 90% of the sample endorsed at least one Criterion A qualifying event, similar to estimates among nationally representative studies on adults and estimates among child welfare involved parents specifically (Chemtob et al, 2011;La Greca et al, 2019). Polyvictimization or exposure to multiple trauma types was also observed, with caregivers reporting an average of between seven and eight Criterion A exposures and between two and three nonqualifying adversities.…”

“…Lifetime exposure to a posttraumatic stress disorder (PTSD) DSM–5 Criterion A trauma is almost inevitable by adulthood, with nationally representative surveys demonstrating that up to 90% of adults experience at least one traumatic event in their lifetime (Forman-Hoffman et al, 2016; La Greca et al, 2019). Some trauma-exposed adults will develop PTSD symptoms that include trauma memory intrusions, avoidance, negative changes in cognition and mood, and alterations in arousal and reactivity, with 10%–25% meeting full PTSD criteria (American Psychiatric Association, 2013; Goldstein et al, 2016).…”

Evacuation- and hurricane-related experiences, emotional distress, and their associations with mothers’ health risk behaviors.

“…Building on this conceptual model (La Greca et al, 2010), the primary aim of the current study was to evaluate whether disaster-related experiences occurring before the storm (as well as experiences during and after the storm) were associated with mothers’ health risk behaviors. The model includes (a) individual predisaster characteristics (e.g., gender, ethnicity, and socioeconomic status [SES]), (b) disaster exposure (e.g., life threat during the event, postdisaster loss and disruption), and (c) postdisaster recovery variables (e.g., social support) as predictors of emotional distress; this model has guided substantial disaster research with youth and adults (e.g., Bonanno et al, 2010; La Greca et al, 2020). Our study focused on the first two factors in the model (individual characteristics, disaster exposure) and extended the model by evaluating evacuation experiences as an aspect of “disaster exposure.” In addition, mothers’ health risk behavior was examined as an important outcome variable; this outcome was expected to be associated with indicators of emotional distress, as discussed further below.…”

“…For example, nearly one fifth of adult survivors of Hurricane Katrina subsequently developed posttraumatic stress disorder (PTSD; McLaughlin et al, 2011), and substantially higher rates of PTSD (48%) have been reported for low income parents (96% mothers; Rhodes et al, 2010). Rates of psychological symptoms vary widely, but are closely linked to the level of life threat experienced during the disaster as well as to disaster-related loss and disruption in the aftermath (Bonanno et al, 2010; La Greca et al, 2020; Sirey et al, 2017).…”

“…This vulnerability may be relevant even before a disaster strikes, as women are more likely to evacuate than men, and parents are more likely to evacuate than nonparents (Thompson et al, 2017). Further, mothers report numerous unique stressors related to evacuation, such as concerns for the safety of their children (La Greca et al, 2020).…”