The importance of the concepts of disaster, catastrophe, violence, trauma and barbarism in defining posttraumatic stress disorder in clinical practice

Author(s)

Braga, Luciana L. ^[1] ; Fiks, Jose P. ; Mari, Jair J. ; Mello, Marcelo F.

Affiliation

^[1] Univ Fed Sao Paulo, Escola Paulista Med, Dept Psychiat, Grad Program Psychiat, Sao Paulo - Brazil

• Document type: Journal article
• Source: BMC Psychiatry; v. 8, p. 0-0, Aug. 2008.
• Field of knowledge: Health Sciences - Medicine
• Web of Science Citations: 8

Abstract

Several terms in the scientific literature about posttraumatic stress disorder are used with different meanings in studies conducted by different authors. Words such as trauma, violence, catastrophe, disaster and barbarism are often used vaguely or confusingly, and their meanings change in different articles. The lack of conceptual references for these expressions complicates the organization of literature. Furthermore, the absence of clear concepts may be an obstacle to clinical treatment because the use of these words by the patients does not necessarily point to a diagnosis of posttraumatic stress disorder. A critical review of scientific literature showed that stress can be divided in stages to facilitate specific terminological adjustments to the event itself, to the subject-event interaction and to psychological responses. Moreover, it demonstrated that the varying concept of trauma expands into fundamental psychotherapeutic definitions and that the meanings of violence associated with barbarism are an obstacle to resilience. Therefore, this study updates the etymological origins and applications of these words, connects them to the expansions of meanings that can be operated in the clinical care of patients with posttraumatic stress disorder, and analyzes them critically according to the criterion A of DSM-IV and ICD-10. The terminology in the literature about posttraumatic stress disorder includes a plethora of terms whose meanings are not fully understood, and that, therefore, limit this terminology. The analysis of these terms suggested that the transformation of the concept of trauma led to a broader understanding of this phenomenon in its psychic dimensions, that a barbarian type of violence constitutes an obstacle to resilience, and that the criterion A of the DSM-IV and ICD-10 shows imprecision and conceptual fragilities... (AU)

• FAPESP's process: 04/15039-0 - Post-traumatic stress disorder: epidemiology, physiopathology and treatment
• Grantee: Jair de Jesus Mari
• Support Opportunities: Research Projects - Thematic Grants