What causes psychological trauma

Psychiatry, Psychosomatics & Psychotherapy


Acute stress reaction

An acute stress reaction can occur after an extraordinary physical or mental stress (stressor), e.g. after a natural disaster, after an accident or rape. An acute stress reaction usually occurs a few minutes after the acute stress. Without the terrible experience, those affected would not lose their psychological balance. The acute stress reaction usually subsides within hours or days, or at least does not last longer than a month. The acute stress reaction is characterized by diverse, often rapidly changing symptoms:

  • Narrowing of consciousness, disorientation and attention deficit, the person concerned is numb, i.e. there is an inner distancing (peritraumatic dissociation) from what has been experienced.
  • Social withdrawal
  • Inability to put what happened in words: "Speechless horror"
  • Restlessness and hyperactivity
  • Increased level of arousal, irritability
  • Physical symptoms e.g. sweating, reddening / paleness, accelerated heart activity, nausea, head pressure
  • Possibly partial or complete memory gap (amnesia) regarding the event

Treatment often begins with initial aid as a brief crisis intervention - for example at the scene of the accident or disaster. Depending on the event, the rescue workers check any complications, i.e. shock or anxiety, risk of suicide, etc., and take appropriate measures. Otherwise, the affected person is guaranteed or organized in his or her social network. This is especially important when helpless people or children need to be looked after. Cognitive behavioral interventions have been well documented in terms of their effectiveness. In the case of strong excitement, psychotropic drugs can be administered briefly to calm down.

With adequate treatment, the prognosis is favorable. However, the acute stress reaction often turns into a post-traumatic stress disorder.

Post Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) can occur as a delayed response to a stressful event or a situation of exceptional threat or disaster-like proportions. These triggering experiences (trauma) can objectively affect almost everyone psychologically, such as serious accidents, violent crimes, natural disasters or acts of war. The diagnosis of post-traumatic stress disorder is made when typical symptoms persist in stressful form for more than four weeks.

PTSD is covered in detail in the article Post Traumatic Stress Disorder (PTSD).

Adjustment disorder

An adjustment disorder is based on an identifiable psychosocial burden (e.g. death of the partner, separation, serious illness, unemployment, conflict at work, birth of a child) that is of no extraordinary or catastrophic extent, but brings about a decisive change in life. Due to the event or during the adjustment process, subjective distress and emotional impairments occur, which limit the perception of social functions and the performance of the person concerned.

Adjustment disorders are discussed in detail in the article Adjustment Disorders.