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In Brief: Post-traumatic stress without trauma

In Brief

Post-traumatic stress without trauma

A study published in June 2005 challenges the accepted view of reactions to trauma by showing that experiences not usually regarded as traumatic can cause the characteristic symptoms of post-traumatic stress disorder (PTSD).

More than 800 patients from a family practice answered a questionnaire comparing symptoms that follow a traumatic event — one outside the range of normal human experience — with symptoms following more common "life events" such as illness or problems in work and personal relationships.

Subjects were asked whether they had ever experienced a traumatic event — a serious accident, witnessing violence, the sudden and unexpected death of someone they loved, physical or sexual abuse, a war or natural disaster. They were also asked whether they had ever experienced such life events as a burglary, marital conflict, study or work problems, chronic illness, or the death of a loved one that was not sudden or unexpected. Finally, they were asked about the worst event they had ever experienced and when it occurred.

Then they checked off a list of statements representing the three basic types of post-traumatic stress symptoms: reexperiencing the trauma, avoidance and emotional numbing, and excessive anxiety or arousal. They stated whether they had experienced these symptoms never, occasionally, or continuously during the previous month.

About 60% of the subjects described a non-traumatic event as the worst in their lives. Surprisingly, life events were as likely as traumatic events to cause symptoms typical of post-traumatic stress disorder. In fact, people whose worst event was not traumatic had more post-traumatic stress symptoms for a longer time than those whose worst event was traumatic. The difference was modest but statistically unmistakable.

The authors suggest that life events may increase overall psychological stress and distress, bringing on symptoms related to an earlier trauma. Traumatic events may reduce the ability to cope with other kinds of stress. Both traumatic experiences and overall distress may increase the risk of developing post-traumatic symptoms after either a traumatic experience or a non-traumatic life event. This tangle of cause and effect suggests that we understand less than we think about the consequences of different kinds of misfortune.

Mol SSL, et al. "Symptoms of Post-Traumatic Stress Disorder After Non-Traumatic Events: Evidence from an Open Population Study," British Journal of Psychiatry (June 2005): Vol. 186, No. 6, pp. 494–499.

Last updated:	September 05, 2008