The impact of trauma and how to intervene : a narrative review ofpsychotraumatology over the past 15 years

To mark 15 years of the European Journal of Psychotraumatology, editors reviewed the past 15-year years of research on trauma exposure and its consequences, as well as developments in(early) psychological, pharmacological and complementary interventions. In all sections of thispaper, we provide perspectives on sex/gender aspects, life course trends, and cross-cultural/global and systemic societal contexts. Globally, the majority of people experience stressfulevents that may be characterized as traumatic. However, definitions of what is traumatic arenot necessarily straightforward or universal. Traumatic events may have a wide range oftransdiagnostic mental and physical health consequences, not limited to posttraumaticstress disorder (PTSD). Research on genetic, molecular, and neurobiological influences showpromise for further understanding underlying risk and resilience for trauma-relatedconsequences. Symptom presentation, prevalence, and course, in response to traumaticexperiences, differ depending on individuals’ age and developmental phase, sex/gender,sociocultural and environmental contexts, and systemic socio-political forces. Earlyinterventions have the potential to prevent acute posttraumatic stress reactions fromescalating to a PTSD diagnosis whether delivered in the golden hours or weeks aftertrauma. However, research on prevention is still scarce compared to treatment researchwhere several evidence-based psychological, pharmacological and complementary/integrative interventions exist, and novel forms of delivery have become available. Here, wefocus on how best to address the range of negative health outcomes following trauma, howto serve individuals across the age spectrum, including the very young and old, and includeconsiderations of sex/gender, ethnicity, and culture in diverse contexts, beyond Western,Educated, Industrialized, Rich, and Democratic (WEIRD) countries. We conclude withproviding directions for future research aimed at improving the well-being of all peopleimpacted by trauma around the world. The 15 years EJPT webinar provides a 90-minutesummary of this paper and can be downloaded here [http://bit.ly/4jdtx6k].

HIGHLIGHTS

• Defining trauma is complex and multifaceted with survivors’ subjective interpretation of an experience being more important than the objective characteristics of an event. Research needs to consider sex/gender, age, and geographical and cultural contexts in defining trauma.
• Trauma may have multiple, often comorbid, mental and physical health outcomes, calling for transdiagnostic screening of trauma survivors. Assessments need to be improved to capture sex/gender differences, young and older trauma survivors and cultural contexts.
• Several (innovative) evidence-based interventions are available for prevention and treatment of trauma outcomes, but more research is needed on if and how to adapt these for optimal efficacy across sex/genders, the life span and local cultural contexts.