An Overview of Trauma and Stressor-Related Disorders

Table of ContentsView AllTable of ContentsTypes of Trauma and Stressor-Related DisordersStress DisordersAdjustment DisordersDissociative DisordersAttachment DisordersTreatmentPrevention

Table of ContentsView All

View All

Table of Contents

Types of Trauma and Stressor-Related Disorders

Stress Disorders

Adjustment Disorders

Dissociative Disorders

Attachment Disorders

Treatment

Prevention

Manymental disordersare associated with trauma and stress. What makes a disorder trauma and stressor-related are the types of events that may have caused the issue, the specific symptoms you’re dealing with, and the duration of these symptoms.

Many researchers believe that these disorders need further exploration to determine treatment methods, a more expansive research collection, and clearer classifications in the DSM-5.Some researchers suggest revisions to the DSM-5 regarding most stressors and trauma-related disorders.

There are many types of trauma and stress-related disorders with different sub-categories, symptoms, and diagnostic criteria. You can explore these disorders below;

Post-traumatic stress disorder (PTSD) is the most recognized trauma and stress-related disorder, and acute stress disorder (ASD) is the temporary version of PTSD.

Post-Traumatic Stress Disorder (PTSD)

PTSD occurs as a result of a traumatic event. It is diagnosed in 5%-10% of the population and is recognized twice as much in women than men. Symptoms must persist for more than a month to be considered PTSD, and individuals must meet various diagnostic criteria, which we’ll explore below.

PTSD vs. ASD

Post-traumatic stress disorder (PTSD) and acute stress disorder have the same symptoms but different duration in which symptoms persist. PTSD is when these symptoms are chronic, whereas, for ASD, symptoms are present for no more than a month.

To be identified as ASD, symptoms occur within a month of a traumatic event (between 2 days to 4 weeks). Most individuals diagnosed with ASD are eventually diagnosed with PTSD.

DSM-5 Diagnostic Criteria

Diagnostic criteria for PTSD pertain to those six years or older. There are multiple clusters and symptom specifications for PTSD.

Acute Stress Disorder

ASD has the same criteria as PTSD, except for the duration of symptoms and a few other minor differences, such as types of dissociative reactions.

PTSD dissociative subtype requires an individual to have experiences of derealization (feeling detached from self, like an outside viewer) or depersonalization (feeling detached from surroundings, as if in a dreamlike state). A person can meet criteria for PTSD without this specifier.

As for ASD, an individual must meet at least three dissociative reactions.Derealization and depersonalizationare included in the list, along with; feeling numb, having a “reduced awareness of one’s surroundings”, and experiencing “dissociative amnesia”.

AD most often occurs during a period of time when the stressor of the trauma is present but subsides when that stressor is removed. These disorders are suspected of subsiding naturally once an individual adjusts to the traumatic event. However, stressors can remain in someone’s life for a long time.

Adjustment disorders can also be the outcome of a significant life stressor or significant change in a person’s life.

One research study found that 36% of adult and 59% of adolescent participants experienced the stressor of their trauma for over a year.A follow-up assessment was conducted five years later, and most of the adult participants recovered in the past five years.

The study’s adults (70%) improved more than adolescents (45%).Most of the other participants were diagnosed with other mental health disorders besides AD. There is also a correlation between having AD as a child or adolescent and developing other mental disorders as an adult.

AD has six diagnostic criteria in the DSM-5:

According to the DSM-5,dissociationis a disconnect from ‘‘usually integrated functions of consciousness, memory, identity, or perception.”With dissociative behavior, you may experience some form of detachment from yourself, others, your surroundings, or your perspective of reality. Research has shown that dissociation also impacts “thinking, emotions, sensorimotor functioning, and/or behavior”.

DDs can be diagnostic criteria for other disorders like PTSD and ASD. Symptoms of DDs are also associated with mood disorders, personality disorders, and substance abuse.

To meet the DSM-5’s criteria for a DD, one must experience the following dissociative symptoms;

Reactive attachment disorder (RAD) anddisinhibited social engagement disorder (DSED)have recently been acknowledged in the DSM-5 as two separate subtypes of attachment disorders classified as stress and trauma-related disorders.

Children are usually diagnosed with one of these disorders when behavioral problems are present. Those with either disorder have most likely experienced some form of childhood trauma and a history of abuse with a caregiver.

A journal study found that 12-year-old children in institutional settings in early childhood displayed more symptoms of RAD and DSED than those who were placed and foster care.The group of children who were not institutionalized at all had even fewer signs of these attachment disorders.

Reactive Attachment Disorder

Evidence of RAD is often present before the age of 5.Children with RAD often find it difficult to form healthy relationships, exhibit unpredictable behaviors, and often react in afight, flight or freezeresponse.

RAD vs. DSED

Both RAD and DSED are associated with being emotionally andsocially withdrawn. However, RAD is more associated with being emotionally withdrawn because of the lack of attachment related to inhibited behavior. Individuals are inhibited from forming emotional attachments.

Whereas those with DSED, who are socially withdrawn, engage in disinhibited behaviors. They find it difficult to produce social connections.

Although RAD and DSED have been identified as different forms of attachment, they have similar criteria and symptoms such as;

Although much research has developed on PTSD throughout the years, there is little research on managing most trauma and stressor-related disorders.

Some research considers recovery time a treatment method for certain trauma and stressor-related disorders, like AD. “Treatment generally involves recovering and working through ostensibly repressed or dissociated memories of trauma”.

It is expected for recovery to occur for those experiencing AD once the stressor is removed from an individual’s life. However, the assumption that symptoms of these disorders will resolve over time is not a definitive or clear treatment method.

Psychotherapy and counseling may be considered for those diagnosed with AD.

Cognitive behavioral therapy (CBT)has shown to be an effective treatment method for trauma and stressor-related disorders. An article conducted a systematic review of the impact of CBT on these symptoms. After reviewing a collection of 84 studies, researchers discovered that 65.9% found a dramatic reduction in symptoms.

Other forms of talk therapy, support groups, and psychiatric medication have been used in treating PTSD.Recently, other treatments like cognitive-processing therapy, prolonged exposure therapy, and EMDR have also been explored for PTSD, but more research is needed.

Research inresilience—the ability to adapt in the face of adversity—has also been explored as a preventive measure for post-traumatic stress disorder and other mental illnesses.

There is no surefire way to prevent trauma, however, given that many of the events that may cause it occur without warning. In many cases, the best we can do is act fast to ensure the inciting event does not have long-lasting consequences for our mental health.

Final Thoughts

If you believe your child or yourself may have a trauma and stressor-related disorder, it would be beneficial to contact amental health professionalto gain further insight into these disorders. Speaking with a psychologist or psychiatrist can provide you with an accurate diagnosis and potential treatment methods.

It can be difficult adjusting to stressors, so identifying traumas and stressors in your life is important to practice preventive measures.

19 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stein DJ, Craske MA, Friedman MJ, Phillips KA.Anxiety disorders, obsessive-compulsive and related disorders, trauma- and stressor-related disorders, and dissociative disorders in DSM-5.Am J Psychiatry. 2014;171(6):611-613. doi:10.1176/appi.ajp.2014.14010003Hanson RF, Spratt EG.Reactive Attachment Disorder: what we know about the disorder and implications for treatment.Child Maltreat. 2000;5(2):137-145. doi:10.1177/1077559500005002005Spiegel D, Lewis-Fernández R, Lanius R, Vermetten E, Simeon D, Friedman M.Dissociative disorders in DSM-5.Annu Rev Clin Psychol. 2013;9:299-326. doi:10.1146/annurev-clinpsy-050212-185531Howlett JR, Stein MB.Prevention of Trauma and Stressor-Related Disorders: A Review.Neuropsychopharmacology. 2016;41(1):357-369. doi:10.1038/npp.2015.261Yehuda R, Hoge CW, McFarlane AC, et al.Post-traumatic stress disorder.Nat Rev Dis Primers. 2015;1:15057. doi:10.1038/nrdp.2015.57Center for Substance Abuse Treatment (US).Trauma-Informed Care in Behavioral Health Services.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014.Bryant RA, Friedman MJ, Spiegel D, Ursano R, Strain J.A review of acute stress disorder in DSM-5.Depress Anxiety. 2011;28(9):802-817. doi:10.1002/da.20737Bisson JI, Sakhuja D.Adjustment disorders.Psychiatry (Abingdon, England). 2006;5(7):240-242. doi:10.1053/j.mppsy.2006.04.004Andreasen NC, Wasek P.Adjustment disorders in adolescents and adults.Arch Gen Psychiatry. 1980 Oct;37(10):1166-70. doi: 10.1001/archpsyc.1980.01780230084012. PMID: 7425801Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); June 2016.Şar V.The many faces of dissociation: opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171-179. doi:10.9758/cpn.2014.12.3.171van der Hart O, Dorahy MJ. (2009).History of the concept of dissociation.In P. F. Dell & J. A. O’Neil (Eds.),Dissociation and the dissociative disorders: DSM-V and beyond. 2009:3–26.Zeanah CH, Chesher T, Boris.Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder.J Am Acad Child Adolesc Psychiatry. 2016;55(11):990-1003. doi:10.1016/j.jaac.2016.08.004Humphreys KL, Nelson CA, Fox NA, Zeanah CH.Signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years: Effects of institutional care history and high-quality foster care.Development and Psychopathology. 2017;29(2):675-684. doi:10.1017/S0954579417000256Ellis EE, Yilanli M, Saadabadi A.Reactive Attachment Disorder. In:StatPearls.Treasure Island (FL): StatPearls Publishing; May 8, 2022.Honor G.Reactive Attachment Disorder.Journal of Pediatric Health Care.2008;22(4):234-239. doi:10.1016/j.pedhc.2007.07.003Kalisch R, Baker DG, Basten U, et al.The resilience framework as a strategy to combat stress-related disorders.Nat Hum Behav. 2017;1(11):784-790. doi:10.1038/s41562-017-0200-8Davis AA, Zachry CE, Berkeab DS.Physical interventions for the treatment of trauma and stressor-related disorders: A comprehensive systematic review.Mental Health and Physical Activity. 2021;20. doi:10.1016/j.mhpa.2021.100401.Schrader C, Ross A.A Review of PTSD and Current Treatment Strategies.Mo Med. 2021 Nov-Dec;118(6):546-551. PMID: 34924624; PMCID: PMC8672952

19 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Stein DJ, Craske MA, Friedman MJ, Phillips KA.Anxiety disorders, obsessive-compulsive and related disorders, trauma- and stressor-related disorders, and dissociative disorders in DSM-5.Am J Psychiatry. 2014;171(6):611-613. doi:10.1176/appi.ajp.2014.14010003Hanson RF, Spratt EG.Reactive Attachment Disorder: what we know about the disorder and implications for treatment.Child Maltreat. 2000;5(2):137-145. doi:10.1177/1077559500005002005Spiegel D, Lewis-Fernández R, Lanius R, Vermetten E, Simeon D, Friedman M.Dissociative disorders in DSM-5.Annu Rev Clin Psychol. 2013;9:299-326. doi:10.1146/annurev-clinpsy-050212-185531Howlett JR, Stein MB.Prevention of Trauma and Stressor-Related Disorders: A Review.Neuropsychopharmacology. 2016;41(1):357-369. doi:10.1038/npp.2015.261Yehuda R, Hoge CW, McFarlane AC, et al.Post-traumatic stress disorder.Nat Rev Dis Primers. 2015;1:15057. doi:10.1038/nrdp.2015.57Center for Substance Abuse Treatment (US).Trauma-Informed Care in Behavioral Health Services.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014.Bryant RA, Friedman MJ, Spiegel D, Ursano R, Strain J.A review of acute stress disorder in DSM-5.Depress Anxiety. 2011;28(9):802-817. doi:10.1002/da.20737Bisson JI, Sakhuja D.Adjustment disorders.Psychiatry (Abingdon, England). 2006;5(7):240-242. doi:10.1053/j.mppsy.2006.04.004Andreasen NC, Wasek P.Adjustment disorders in adolescents and adults.Arch Gen Psychiatry. 1980 Oct;37(10):1166-70. doi: 10.1001/archpsyc.1980.01780230084012. PMID: 7425801Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); June 2016.Şar V.The many faces of dissociation: opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171-179. doi:10.9758/cpn.2014.12.3.171van der Hart O, Dorahy MJ. (2009).History of the concept of dissociation.In P. F. Dell & J. A. O’Neil (Eds.),Dissociation and the dissociative disorders: DSM-V and beyond. 2009:3–26.Zeanah CH, Chesher T, Boris.Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder.J Am Acad Child Adolesc Psychiatry. 2016;55(11):990-1003. doi:10.1016/j.jaac.2016.08.004Humphreys KL, Nelson CA, Fox NA, Zeanah CH.Signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years: Effects of institutional care history and high-quality foster care.Development and Psychopathology. 2017;29(2):675-684. doi:10.1017/S0954579417000256Ellis EE, Yilanli M, Saadabadi A.Reactive Attachment Disorder. In:StatPearls.Treasure Island (FL): StatPearls Publishing; May 8, 2022.Honor G.Reactive Attachment Disorder.Journal of Pediatric Health Care.2008;22(4):234-239. doi:10.1016/j.pedhc.2007.07.003Kalisch R, Baker DG, Basten U, et al.The resilience framework as a strategy to combat stress-related disorders.Nat Hum Behav. 2017;1(11):784-790. doi:10.1038/s41562-017-0200-8Davis AA, Zachry CE, Berkeab DS.Physical interventions for the treatment of trauma and stressor-related disorders: A comprehensive systematic review.Mental Health and Physical Activity. 2021;20. doi:10.1016/j.mhpa.2021.100401.Schrader C, Ross A.A Review of PTSD and Current Treatment Strategies.Mo Med. 2021 Nov-Dec;118(6):546-551. PMID: 34924624; PMCID: PMC8672952

Stein DJ, Craske MA, Friedman MJ, Phillips KA.Anxiety disorders, obsessive-compulsive and related disorders, trauma- and stressor-related disorders, and dissociative disorders in DSM-5.Am J Psychiatry. 2014;171(6):611-613. doi:10.1176/appi.ajp.2014.14010003Hanson RF, Spratt EG.Reactive Attachment Disorder: what we know about the disorder and implications for treatment.Child Maltreat. 2000;5(2):137-145. doi:10.1177/1077559500005002005Spiegel D, Lewis-Fernández R, Lanius R, Vermetten E, Simeon D, Friedman M.Dissociative disorders in DSM-5.Annu Rev Clin Psychol. 2013;9:299-326. doi:10.1146/annurev-clinpsy-050212-185531Howlett JR, Stein MB.Prevention of Trauma and Stressor-Related Disorders: A Review.Neuropsychopharmacology. 2016;41(1):357-369. doi:10.1038/npp.2015.261Yehuda R, Hoge CW, McFarlane AC, et al.Post-traumatic stress disorder.Nat Rev Dis Primers. 2015;1:15057. doi:10.1038/nrdp.2015.57Center for Substance Abuse Treatment (US).Trauma-Informed Care in Behavioral Health Services.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014.Bryant RA, Friedman MJ, Spiegel D, Ursano R, Strain J.A review of acute stress disorder in DSM-5.Depress Anxiety. 2011;28(9):802-817. doi:10.1002/da.20737Bisson JI, Sakhuja D.Adjustment disorders.Psychiatry (Abingdon, England). 2006;5(7):240-242. doi:10.1053/j.mppsy.2006.04.004Andreasen NC, Wasek P.Adjustment disorders in adolescents and adults.Arch Gen Psychiatry. 1980 Oct;37(10):1166-70. doi: 10.1001/archpsyc.1980.01780230084012. PMID: 7425801Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); June 2016.Şar V.The many faces of dissociation: opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171-179. doi:10.9758/cpn.2014.12.3.171van der Hart O, Dorahy MJ. (2009).History of the concept of dissociation.In P. F. Dell & J. A. O’Neil (Eds.),Dissociation and the dissociative disorders: DSM-V and beyond. 2009:3–26.Zeanah CH, Chesher T, Boris.Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder.J Am Acad Child Adolesc Psychiatry. 2016;55(11):990-1003. doi:10.1016/j.jaac.2016.08.004Humphreys KL, Nelson CA, Fox NA, Zeanah CH.Signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years: Effects of institutional care history and high-quality foster care.Development and Psychopathology. 2017;29(2):675-684. doi:10.1017/S0954579417000256Ellis EE, Yilanli M, Saadabadi A.Reactive Attachment Disorder. In:StatPearls.Treasure Island (FL): StatPearls Publishing; May 8, 2022.Honor G.Reactive Attachment Disorder.Journal of Pediatric Health Care.2008;22(4):234-239. doi:10.1016/j.pedhc.2007.07.003Kalisch R, Baker DG, Basten U, et al.The resilience framework as a strategy to combat stress-related disorders.Nat Hum Behav. 2017;1(11):784-790. doi:10.1038/s41562-017-0200-8Davis AA, Zachry CE, Berkeab DS.Physical interventions for the treatment of trauma and stressor-related disorders: A comprehensive systematic review.Mental Health and Physical Activity. 2021;20. doi:10.1016/j.mhpa.2021.100401.Schrader C, Ross A.A Review of PTSD and Current Treatment Strategies.Mo Med. 2021 Nov-Dec;118(6):546-551. PMID: 34924624; PMCID: PMC8672952

Hanson RF, Spratt EG.Reactive Attachment Disorder: what we know about the disorder and implications for treatment.Child Maltreat. 2000;5(2):137-145. doi:10.1177/1077559500005002005

Spiegel D, Lewis-Fernández R, Lanius R, Vermetten E, Simeon D, Friedman M.Dissociative disorders in DSM-5.Annu Rev Clin Psychol. 2013;9:299-326. doi:10.1146/annurev-clinpsy-050212-185531

Howlett JR, Stein MB.Prevention of Trauma and Stressor-Related Disorders: A Review.Neuropsychopharmacology. 2016;41(1):357-369. doi:10.1038/npp.2015.261

Yehuda R, Hoge CW, McFarlane AC, et al.Post-traumatic stress disorder.Nat Rev Dis Primers. 2015;1:15057. doi:10.1038/nrdp.2015.57

Center for Substance Abuse Treatment (US).Trauma-Informed Care in Behavioral Health Services.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014.

Bryant RA, Friedman MJ, Spiegel D, Ursano R, Strain J.A review of acute stress disorder in DSM-5.Depress Anxiety. 2011;28(9):802-817. doi:10.1002/da.20737

Bisson JI, Sakhuja D.Adjustment disorders.Psychiatry (Abingdon, England). 2006;5(7):240-242. doi:10.1053/j.mppsy.2006.04.004

Andreasen NC, Wasek P.Adjustment disorders in adolescents and adults.Arch Gen Psychiatry. 1980 Oct;37(10):1166-70. doi: 10.1001/archpsyc.1980.01780230084012. PMID: 7425801

Substance Abuse and Mental Health Services Administration.Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health.Rockville (MD): Substance Abuse and Mental Health Services Administration (US); June 2016.

Şar V.The many faces of dissociation: opportunities for innovative research in psychiatry.Clin Psychopharmacol Neurosci. 2014;12(3):171-179. doi:10.9758/cpn.2014.12.3.171

van der Hart O, Dorahy MJ. (2009).History of the concept of dissociation.In P. F. Dell & J. A. O’Neil (Eds.),Dissociation and the dissociative disorders: DSM-V and beyond. 2009:3–26.

Zeanah CH, Chesher T, Boris.Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder.J Am Acad Child Adolesc Psychiatry. 2016;55(11):990-1003. doi:10.1016/j.jaac.2016.08.004

Humphreys KL, Nelson CA, Fox NA, Zeanah CH.Signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years: Effects of institutional care history and high-quality foster care.Development and Psychopathology. 2017;29(2):675-684. doi:10.1017/S0954579417000256

Ellis EE, Yilanli M, Saadabadi A.Reactive Attachment Disorder. In:StatPearls.Treasure Island (FL): StatPearls Publishing; May 8, 2022.

Honor G.Reactive Attachment Disorder.Journal of Pediatric Health Care.2008;22(4):234-239. doi:10.1016/j.pedhc.2007.07.003

Kalisch R, Baker DG, Basten U, et al.The resilience framework as a strategy to combat stress-related disorders.Nat Hum Behav. 2017;1(11):784-790. doi:10.1038/s41562-017-0200-8

Davis AA, Zachry CE, Berkeab DS.Physical interventions for the treatment of trauma and stressor-related disorders: A comprehensive systematic review.Mental Health and Physical Activity. 2021;20. doi:10.1016/j.mhpa.2021.100401.

Schrader C, Ross A.A Review of PTSD and Current Treatment Strategies.Mo Med. 2021 Nov-Dec;118(6):546-551. PMID: 34924624; PMCID: PMC8672952

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Post-Traumatic Stress Disorder (PTSD)#

PTSD vs. ASD#

DSM-5 Diagnostic Criteria#

Reactive Attachment Disorder#

RAD vs. DSED#

Final Thoughts#