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“Traumatic stress has a broad range of effects on brain function and structure, as well as on neuropsychological components of memory.”
(Bremner, 2006, p. 455)
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KEY POINTS IN THIS CHAPTER
The neurobiology of trauma can affect the functioning of the brain with lasting consequences.
The body’s hormonal response to trauma affects the encoding of memory.
Acute stress disorder (ASD) can result following trauma and can develop into post-traumatic stress disorder (PTSD) if symptoms last for more than 1 month.
Trauma can cause immediate symptoms, such as tonic immobility and dissociation, and may lead to chronic symptoms of depression and anxiety.
Exposure to trauma can cause physical health problems.
Evidence-based psychotherapy treatment options following traumatic exposure are available.
Providing compassionate, nonjudgmental care to victims of trauma helps their healing process.
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Nurses work with many individuals who have suffered trauma as well as those who have inflicted trauma on others. Often, those who perpetrate crimes have been victims of trauma themselves. It is important to understand what occurs physiologically to the person who has experienced trauma and its aftermath. This chapter discusses the neurobiology of trauma, the repercussions of experiencing trauma, and interventions to improve the lives and functioning of traumatized individuals.
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Trauma can be defined in a variety of ways, including bodily injury, a catastrophic occurrence, and psychological and physiological reactions to an overwhelmingly negative event. For the purposes of this chapter, trauma refers to an actual or threatened event that begins with the stress response but continues to negatively impact psychological and physiological functioning.
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Exposure to traumatic events is common in the United States:
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The seminal National Comorbidity Study (NCS) reported that 60% of men and 51% of women experienced a traumatic event in their lifetime (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995).
The most frequently encountered traumas involve a life-threatening accident, a natural disaster, or witnessing a traumatic event that happens to someone else.
Over half of the individuals who experienced trauma reported more than one type of traumatic exposure.
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Post-traumatic stress disorder (PTSD) is a mental disorder frequently associated with exposure to trauma. Although not all individuals exposed to traumatic events develop PTSD, a sizable proportion do, about 29% in the NCS sample. Of the various kinds of traumatic exposure surveyed by the NCS, individuals who faced assault, physical or sexual, were the most likely to develop PTSD (Kessler et al., 1995). Rape, a particularly violent form of assault, is a potent risk factor for PTSD (Ballenger et al., 2000; Tjaden & Thoennes, 2006). The higher incidence of rape and interpersonal violence in women may contribute to the higher prevalence of PTSD in women (American Psychiatric Association [APA], 2013).
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Four neurobehavioral symptom clusters are ...