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The trauma spectrum: The interaction of biological and social events in the genesis of the trauma response

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Journal of Traumatic Stress

Abstract

When Kardiner first described the full syndrome of what is now called PTSD in 1941, he called the trauma response a “physioneurosis,” that is, a mental disorder which affects both the soma and the psyche. Now, more than 40 years later much knowledge has been gained about the biological effects of traumatization. Based on the studies of disruptions of attachment bonds in non-human primates, the animal model of inescapable shock, and numerous studies of traumatized children and adults, we are beginning to understand the nature of the biological changes which underlie the psychological response to trauma. This paper will explore (1) the nature of the biological alterations in response to traumatization, (2) how these biological shifts depend on the maturation of the central nervous system (CNS), cognitive processes, and the social matrix in which they occur, (3) and how these alterations can influence psychopathological and interpersonal processes.

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References

  • Anisman, H. L., Ritch, M., and Sklar, L. S. (1981). Noradrenergic and dopaminergic interactions in escape behavior.Psychopharmacology 74: 263–268.

    Google Scholar 

  • Bach-y-Rita, G. (1974). Habitual violence and self-mutilation.Am. J. Psychiat. 131: 1018–1020.

    Google Scholar 

  • Beck, J., and van der Kolk, B. A. (1987). Behavioral correlates of incest histories in chronically hospitalized women.Am. J. Psychiat. 144: 1474–1476.

    Google Scholar 

  • Blier, P., and de Montigney, C. (1985). Short term lithium administration enhances serotonergic transmission.Eur. J. Pharmacol. 112: 415–418.

    Google Scholar 

  • Bowlby, J. (1969).Attachment and Loss, Volume I, Attachment Basic Books, New York.

    Google Scholar 

  • Bowlby, J. (1973).Attachment and Loss, Volume 2, Separation Basic Books, New York.

    Google Scholar 

  • Bowlby, J. (1984). Violence in the family as a disorder of the attachment and caregiving systems.Am. J. Psychoanal. 44: 9–27.

    Google Scholar 

  • Brett, E. A., and Ostroff, R. (1985). Imagery and post-traumatic stress disorder: An overview.Am. J. Psychiat. 142: 417–424.

    Google Scholar 

  • Brown, G. L., Ebert, M. H., and Goyer, P. (1982). Aggression, suicide and serotonin.Am. J. Psychiat. 134: 741–745.

    Google Scholar 

  • Bryer, J. B., Nelson, B. A., Baker Miller, J., and Krol, P. (1987). Childhood sexual and physical abuse as factors in adult psychiatric illness.Am. J. Psychiat. 144: 1426–1430.

    Google Scholar 

  • Bunney, W. E., and Garland, B. L. (1984). Lithium and its possible mode of action. In Post, R. M., and Ballenger, J. C. (eds.),Neurobiology of Mood Disorders Williams and Wilkins, Baltimore, pp. 731–743.

    Google Scholar 

  • Burgess, A. W., and Holstrom, E. (1979). Adaptive strategies in recovery from rape.Am. J. Psychiat. 136: 1278–1282.

    Google Scholar 

  • Burgess, A. W., Hartmann, C. R., and McCormack, A. (1987). Abused to abuser: Antecedents of socially deviant behavior.Am. J. Psychiat. 144: 1431–1436.

    Google Scholar 

  • Carmen, E. H., Reiker, P. P., and Mills, T. (1984). Victims of violence and psychiatric illness.Am. J. Psychiat. 141: 378, 379.

    Google Scholar 

  • Cicchetti, D. (1984). The emergence of developmental psychopathology.Child Dev. 55: 1–7.

    Google Scholar 

  • Christie, M. J., and Chesher, G. B. (1982). Physical dependence on physiologically released endogenous opiates.Life Sci. 3): 1173–1177.

    Google Scholar 

  • Coe, C. L., Mendoza, S. P., and Smotherman, W. P. (1978). Mother-infant attachment in the squirrel monkey: Adrenal responses to separation.Behav. Biol. 22: 256–263.

    Google Scholar 

  • Coe, C. L., Glass, J. C., and Wiener, S. G. (1983). Behavioral, but not physiological adaptation to repeated separation in mother and infant primates.Psychoneuroendocrinology 8: 401–409.

    Google Scholar 

  • Cohen, M. R., Pichas, D., and Dubois, M. (1982). Stress induced plasma beta endorphin immunoreactivity may predict postoperative morphine.Psychiat. Res. 6: 7–12.

    Google Scholar 

  • Coid, J., Allolio, B., and Rees, L. H. (1983). Raised plasma metenkephalin in patients who habitually mutilate themselves.Lancet 545–546.

  • Colt, E. W., Wardlaw, S. L., and Frantz, A. G. (1981). The effect of running on plasma beta endorphin.Life Sci. 28: 1637–1640.

    Google Scholar 

  • Delaney, R., Tussi, D., and Gold, P. E. (1983). Long-term potentiation as a neurophysiological analog of memory.Pharm. Biochem. Behav. 18: 137–139.

    Google Scholar 

  • Dobbs, D., and Wilson, W. P. (1960). Observations on the persistence of traumatic war neurosis.J. Ment. Nerv. Dis. 21: 40–46.

    Google Scholar 

  • Eich, J. E. (1980). The cue dependent nature of state dependent retrieval.Memory Cog. 8: 157–168.

    Google Scholar 

  • Emde, R. N. (1982).The Development of Attachment and Affiliative Systems Plenum Press, New York.

    Google Scholar 

  • Fabre-Nys, C., Meller, R. E., and Keverne, E. G. (1982). Opiate antagonists stimulate affilitate behavior in monkeys.Pharmacol. Biochem. Behav. 6: 653–659.

    Google Scholar 

  • Field, T. (1985). Attachment as psychobiological attunement: Being on the same wavelength. In Reite, M., and Field, T. (eds.),The Psychobiology of Attachment and Separation Academic Press, Orlando, Fla.

    Google Scholar 

  • Field, T. and Reite, M. (eds.), (1985).The Psycho-Biology of Attachment and Separation Academic Press, Orlando.

    Google Scholar 

  • Fish-Murray, C., Koby, E., and van der Kolk, B. A. (1987). The effect of abuse on children's thought. In van der Kolk, B. A. (ed.),Psychological Trauma American Psychiatric Press, Washington DC.

    Google Scholar 

  • Freud, S. (1919). Introduction to psychoanalysis and the war neuroses. InComplete Psychological Works, Volume 17 (Strachy, J., ed. and trans.), Hogarth Press, London, 1959.

    Google Scholar 

  • Freud, S. (1920).Beyond the pleasure principle, inComplete Psychological Works, Standard edition, Volume 18 (Strachey, J., ed. and trans.), Hogarth Press, London, 1959.

    Google Scholar 

  • Gold, P. E., and Zornetzer, S. F. (1983). The mnemon and its juices: Neuromodulation of memory processes.Behav. Neural Biol. 38: 151–189.

    Google Scholar 

  • Green, A. H. (1978). Self-destructive behavior in battered children.Am. J. Psychiat. 135: 579–582.

    Google Scholar 

  • Grinker, R. R., and Spiegel, J. J. (1945).Men under Stress McGraw-Hill, New York.

    Google Scholar 

  • Helzer, J. E., Robins, L. N., and McEvoy, L. (1987). Post-traumatic stress disorder in the general population.N. Engl. J. Med. 26: 1630–1634.

    Google Scholar 

  • Hendin, H., Pollinger Haas, A., and Singer, P. (1983). The influence of precombat personality on post-traumatic stress disorders.Comp. Psychiat. 24: 530–534.

    Google Scholar 

  • Herman, J. (1985): Histories of violence in an outpatient clinic.Am. J. Orthopsychiat. 57: 137–141.

    Google Scholar 

  • Holen, A. (1987).The long term psychological effects of an oil rig disaster, Paper presented at the fourth annual conference of the Society for Traumatic Stress Studies, Baltimore.

  • Horowitz, M. J. (1976).Stress Response Syndromes Jason Aronson, New York.

    Google Scholar 

  • Janal, M. N., Colt, E. W. D., Clark, W. C. and Glusman, M. (1984). Pain sensitivity, mood and plasma endocrine levels in man following long-distance running: Effects of naloxone.Pain 19: 13–25.

    Google Scholar 

  • Jacobs, W. J., and Nadel, L. (1985). Stress-induced recovery of fears and phobias.Psychol. Rev. 92: 512–531.

    Google Scholar 

  • Kardiner, A. (1941).The Traumatic Neuroses of War P. Hoeber, New York.

    Google Scholar 

  • Kelly, D. D. (1982). The role of endorphins in stress-induced analgesia.Ann. N. Y. Acad. Sci. 398, 260–271.

    Google Scholar 

  • Kihlstrom, J. F. (1984). Conscious, subconscious, unconscious: A cognitive perspective. In Bowers, K. S., and Meichenbaum, D. (eds.),The Unconscious Reconsidered Wiley, New York.

    Google Scholar 

  • Kilpatrick, D. G., Vernonen, L. J., and Best, C. L. (1985). Factors predicting psychological distress in rape victims. In Figley, C. (ed.),Trauma and Its Wake Brunner/Mazel, New York, pp. 113–141.

    Google Scholar 

  • Kolb, L. C., and Multipassi, L. R. (1982). The conditioned emotional response: A subclass of chronic and delayed post-traumatic stress disorder.Psychiatric Annals 12: 979–987.

    Google Scholar 

  • Kolb, L. (1987). Neuropsychological hypothesis explaining post-traumatic stress disorder.Am. J. Psychiat. 144: 989–995.

    Google Scholar 

  • Konner, M. (1982). Biological aspects of the mother-infant bond. In Emde, R. N., and Harmon, R. J. (eds.),The Development of Attachment and Affiliative Systems Plenum, New York.

    Google Scholar 

  • Kraemer, G. W. (1985). Effects of differences in early social experiences on primate neurobiological-behavioral development. In Reite, M., and Field, T. (eds.),The Psychobiology of Attachment and Separation Academic Press, Orlando, Fla.

    Google Scholar 

  • Kraemer, G. W., Ebert, M. H., Lake, C. R., and McKinney, G. W. (1984). Hypersensitivity to d-amphetamine several years after early social deprivation in rhesus monkeys.Psychopharmacology 82: 266–271.

    Google Scholar 

  • Kramer, M., Schoen, L. S., Kinney, L. (1984). The dream experience in dream disturbed Vietnam veterans. In van der Kolk, B. A. (ed.),Post-traumatic Stress Disorder: Psychological and Biological Sequelae American Psychiatric Press, Washington D. C.

    Google Scholar 

  • Krystal, H. (1968).Massive Psychic Trauma International Universities Press, New York.

    Google Scholar 

  • Krystal, H. (1984). Psychoanalytic views on human emotional damages. In van der Kolk, B. (ed.).Post-traumatic Stress Disorder: Psychological and Biological Sequelae APA Press, Washington D. C., pp. 1–28.

    Google Scholar 

  • Laudenslager, M., Capitano, J. P., and Reite, M. (1985). Possible effects of early separation on subsequent immune function in adult macaque monkeys.Am. J. Psychiat. 142: 862–864.

    Google Scholar 

  • Lindemann, E. (1942). Symptomatology and management of acute grief.Am. J. Psychiat. 101: 141–148.

    Google Scholar 

  • Lindy, J. (1987).Vietnam, a Case Book Brunner/Mazel, New York.

    Google Scholar 

  • Lipper, S., Davidson, J. R. T., and Grady, T. A. (1986). Preliminary study of carbamezapine in post-traumatic stress disorder.Psychosomatics 27: 849–854.

    Google Scholar 

  • MacLean, P. D. (1985). Brain evolution relating to family, play, and the separation call.Arch. Gen. Psychiat. 42: 505–417.

    Google Scholar 

  • Maier, S. F., Davies, S., and Grau, J. W. (1980). Opiate antagonists and long term analgesic reacton induced by inescapable shock in rats.J. Comp. Psychol. 105: 3–46

    Google Scholar 

  • Maier, S. F., and Seligman, M. E. P. (1976). Learned helpnessness: Theory and evidence.J. Exp. Psychiat. Gen. 105: 3–46.

    Google Scholar 

  • Malloy, P. F., Fairbank, J. A., and Keane, T. M. (1983). Validation of a multimethod assessment of post-traumatic stress disorders in Vietnam veterans.J. Consult. Clin. Psychol. 51: 4–21.

    Google Scholar 

  • McCahill, T. W., Meyer, L. C., and Fishman, A. M. (1979).The Aftermath of Rape Heath, Lexington, Mass.

    Google Scholar 

  • Mitchell, D., Osborne, E. W., and O'Boyle, M. W. (1985). Habituation under stress: Shocked mice show non-associative learning in a T-maze.Behav. Neur. Biol. 43: 212–217.

    Google Scholar 

  • Neisser, U. (1967).Cognitive Psychology Prentice Hall, Englewood Cliffs, N. J.

    Google Scholar 

  • Newman, J. D., Murphy, M. R., and Harbough, C. R. (1982). Naloxone-reversible suppression of isolation call production after morphine injections in squirrel monkeys.Soc. Neur. Abstr. 8: 940.

    Google Scholar 

  • Panksepp, J. (1980). Brief social isolation, pain responsivity and morphine analgesia in young rats.Psychopharmacology 72: 110–112.

    Google Scholar 

  • Panksepp, J., Sivey, S. M., and Normansell, L. A. (1985). Brain opioids and social emotions. In Reite, M., and Field, T. (eds.),The Psychobiology of Attachment and Separation Academic Press, Orlando, Fla., pp. 3–49.

    Google Scholar 

  • Pattison, E. M., and Kahan, J. (1983). The deliberate self-harm syndrome.Am. J. Psychiat. 140: 867–872.

    Google Scholar 

  • Piaget, J. (1970).Structuralism Basic Books, New York.

    Google Scholar 

  • Pitman, R., Orr, S., Laforgue, D., and DeJong, J. (1987). Psychophysiology of PTSD imagery in Vietnam combat veterans.Arch. Gen. Psychiat. 44.

  • Pitman, R., Orr, S., van der Kolk, B., and Greenberg, M. Opioid mediated stress induced analgesia in Vietnam Veterans with PTSD (submitted for publication).

  • Pynoos, R. S., and Eth, S. (1985). Developmental perspective on psychic trauma in childhood. In Figley, C. R. (ed.),Trauma and Its Wake Brunner/Mazel, New York.

    Google Scholar 

  • Putnam, F. W., Guroff, J. J., and Silberman, E. K. (1986). The clinical phenomenology of Multiple Personality Disorder.J. Clin. Psychiat. 47: 285–293.

    Google Scholar 

  • Rainey, J. M., Aleem, A., Oritz, A., Yaragani, V., Pohl, R., and Berchow, R. (1987). Laboratory procedure for the inducement of flashbacks.Am. J. Psychiat. 144: 1317–1319.

    Google Scholar 

  • Rajecki, D. W., Lamb, M. E., and Obmascher, P. (1978). Toward a general theory of infantile attachment: A comparative review of aspects of the social bond.Behav. Brain Sci. 3: 417–464.

    Google Scholar 

  • Reite, M., Short, R., and Seiler, C. (1981). Attachment, loss and depression.J. Child Psychol. Psychiat. 22: 141–169.

    Google Scholar 

  • Richardson, J. S., and Zaleski, W. A. (1983). Naloxone and self-mutilation.Biol. Psychiat. 18: 99–101.

    Google Scholar 

  • Sapolsky, R., Krey, L., and McEwen, B. S. (1984). Stress down-regulates corticosterone receptors in a site specific manner in the brain.Endocrinology 114: 287–292.

    Google Scholar 

  • Sherman, A. D., and Petty, F. (1980). Neurochemical basis of the action of antidepressants on learned helplessness.Behav. Neurol. Biol. 30: 119–134.

    Google Scholar 

  • Shore, J. H., Tatum, E. L., and Vollmer, W. M. (1986). Psychiatric reactions to disaster: The Mount St. Helens experience.Am. J. Psychiat. 143: 590–595.

    Google Scholar 

  • Shoularsh, J. (1987).Combat addiction, Paper presented at the Fourth Annual Meeting of the Society for Traumatic Stress Studies, Baltimore.

  • Simpson, C. A., and Porter, G. L. (1981). Self-mutilation in children and adolescents.Bull. Menn. Clin. 45: 428–438.

    Google Scholar 

  • Spiegel, D. (1981). Vietnam grief work using hypnosis.Am. J. Clin. Hypnosis 24: 33–40.

    Google Scholar 

  • Spitz, R. (1945). Hospitalism: An inquiry into the genesis of psychiatric conditions in early childhood.Psychoanalytic Study Child 1: 53–74.

    Google Scholar 

  • Squire, L. R. (1987).Memory and the Brain Oxford University Press, New York.

    Google Scholar 

  • Stoddard, F. (1985).Stress disorders in burned children and adolescents, Paper presented at the Annual Meeting of the American Psychiatric Association, Dallas.

  • Strian, F., and Klicpera, C. (1978). Die Bedeuting psychoautonomische Reaktionen im Entstehung und Persistenz von Angstzustanden.Nervenartzt 49: 576–583.

    Google Scholar 

  • Tennes, K. (1982). The role of hormones in mother-infant transactions. In Emde, R. N., and Harmon, R. J., (eds.),The Development of Attachment and Affiliative Systems Plenum, New York, pp. 75–80.

    Google Scholar 

  • Terr, L. (1979). Children of Chowchilla, a study of psychic trauma.Psychoanalytic Study Child 34: 547–623.

    Google Scholar 

  • Terr, L. (1983). Chowchilla revisited: The effects of psychic trauma four years after a school bus kidnapping.Am. J. Psychiatry 140: 1543–1550.

    Google Scholar 

  • van der Kolk, B. A. (1983). Psychopharmacological issues in post-traumatic stress disorder.Hosp. Comm. Psychiat. 34: 683–691.

    Google Scholar 

  • van der Kolk, B. A. (1987).Psychological Trauma American Psychiatric Press, Washington D. C.,

    Google Scholar 

  • van der Kolk, B. A., Blitz, R., Burr, W., Sherry, S., and Hartmann, E. (1984). Nightmares and trauma.Am. J. Psychiat. 141: 187–190.

    Google Scholar 

  • van der Kolk, B. A., and Ducey, C. P. (1984). Clinical implications of the Rorschach in post-traumatic stress. In van der Kolk, B. A. (ed.),Post-traumatic Stress Disorder: Psychological and Biological Sequelae American Psychiatric Press, Washington, D. C.

    Google Scholar 

  • van der Kolk, B. A., Greenberg, M. S., Boyd, H., and Krystal, J. (1985). Inescapable shock, neurotransmitters and addition to trauma: Towards a psychobiology of post-traumatic stress.Biological Psychiat. 20: 314–325.

    Google Scholar 

  • van der Kolk, B. A., Herman, J. L., and Perry, C. (1987).Traumatic antecedents of borderline personality disorder, Paper presented at the Fourth Annual Meeting of the Society for Traumatic Stress Studies, Baltimore.

  • Visintainer, M. A., Volpicelli, J. R., and Seligman, M. E. P. (1982). Tumor rejection in rats after inescapable shock.Science 216: 437–439.

    Google Scholar 

  • Weiss, J. M., Glazer, H. I., Pohorecky, L. A.,et al. (1975): Effects of chronic exposure to stressors on subsequent avoidance-escape behavior and on brain norepinephrine.Psychosom. Med. 37: 522–524.

    Google Scholar 

  • White, S. H., and Pillemer, D. B. (1979). Childhood amnesia and the development of a socially accessible memory system. In Kihlstrom, J. F., and Evans, F. J. (eds.),Functional Disorders of Memory, Hillsdale, N. J.

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  1. MMHC Trauma Center, Harvard Medical School, 74 Fenwood Road, 02115, Boston, Massachusetts

    Bessel A. van der Kolk

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van der Kolk, B.A. The trauma spectrum: The interaction of biological and social events in the genesis of the trauma response. J Trauma Stress 1, 273–290 (1988). https://doi.org/10.1007/BF00974765

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