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

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

Author Braga, Luciana Lorens Autor UNIFESP Google Scholar
Fiks, Jose Paulo Autor UNIFESP Google Scholar
Mari, Jair de Jesus Autor UNIFESP Google Scholar
Mello, Marcelo Feijó de Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background: 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.Discussion: 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.Summary: 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.Methods: To develop this debate article, a current specialized literature review was achieved by searching and retrieving the key terms from two major databases: PubMed and PsycINFO. the key terms included disaster, catastrophe, barbarism, terrorism, trauma, psychic trauma and violence, also in combination with the terms PTSD, concept and conceptual aspects. the data were captured specially from review articles. the included studies were those mostly identified by the authors as relevant by the presence of a conceptual approach in any part of the paper. Researches that relied solely on empirical indicators, like psychopathological, neurobiological or pharmacological aspects, were excluded. the focus here was in conceptual aspects, even when some few empirical studies were included.As it was noted a paucity of medical references related to conceptual aspects of these terms, a wider literature needed to be included, including chapters, books and articles proceeded from the Humanities areas. Interdisciplinary research is needed in this area to include perspectives from a range of different disciplines once that to promote public health (...) new dimensions of such interactions and the implications thereof should be pursued in collaboration with researchers from broader areas [ 1].
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Millennium Institute
National Research Council
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Grant number FAPESP: 04/15039-0
CNPq: 42.122/2005-2
Date 2008-08-12
Published in Bmc Psychiatry. London: Biomed Central Ltd, v. 8, 8 p., 2008.
ISSN 1471-244X (Sherpa/Romeo, impact factor)
Publisher Biomed Central Ltd
Extent 8
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000259333700001

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