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Post Traumatic Recovery

There is a wide diversity of life trajectories following trauma. Research has identified several positive post-traumatic life trajectories such as resilience, post-traumatic growth (PTG) and recovery. A number of problematic post-traumatic trajectories have also been distilled such as delayed symptom and chronic symptom trajectories.
© University of Glasgow
A line graph showing trajectories following trauma. The x-axis shows time since traumatic event, the y-axis shows level of general functioning. The graph shows post-traumatic growth, resilience, recovery, delayed symptoms and chronic symptoms. 

Post-Traumatic Trajectories

There is a wide diversity of life trajectories following trauma. Research has identified several positive post-traumatic life trajectories such as resilience, post-traumatic growth (PTG) and recovery. A number of problematic post-traumatic trajectories have also been distilled such as delayed symptom and chronic symptom trajectories.

Resilient trajectory This response is often characterised by successful adaptation to the trauma-induced stress leading to well-adjusted day-to-day life. Acute stress reactions may still occur such that the individual experiences shock, anguish, terror and confusion. However, individuals manage to regain mental and emotional balance relatively soon after exposure so that PTSD is very unlikely to develop.
Recovery trajectory Recovery involves experiencing PTSD and/or other severe post-traumatic problems but later regaining good general functioning. Recovery is often non-linear and can involve both periods of progress and setbacks. A range of factors have been proposed to affect recovery such as social and economic resources, access to care and personality characteristics. Notably, ‘natural recovery’, or recovery without formal interventions, has also been reported to occur although the reasons for that are not fully understood.
Post-traumatic growth In contrast to the resilient trajectory, PTG entails the emergence of behaviours, attitudes and values that were not present before the traumatic event. Such changes may concern spiritual development, enhanced relationships with others, wisdom and gratitude. Distress can still occur during a growth trajectory. By definition, trauma and distress are key catalysts for growth. However, distress is expected to gradually diminish over time.
Delayed symptoms This trajectory is defined by low levels of acute symptoms shortly after exposure, which gradually develops into subclinical symptoms and, eventually, into full diagnosis (Le Brocque et al., 2009). In the case of delayed-onset PTSD, individuals develop full symptomatology after a prolonged symptom-free period.
Chronic symptoms The classic trajectory of PTSD representing an abrupt, severe and lasting change in the individual’s capacity to manage stress and cope with daily life. Some affected individuals and communities may experience a dramatic sense of loss, panic and hopelessness, which can quickly develop into a range of maladaptive responses such as unresolved grief, anxiety disorders, and PTSD.

Post-Traumatic Recovery Factors

Research is still unable to explain or predict with confidence one’s post-traumatic trajectory. Ongoing research into risk and protective factors will likely make health professionals, families and communities better equipped to successfully manage adverse trauma reactions.

References

Ford, J. D., Grasso, D. J., Elhai, J. D., & Courtois, C. A. (2015). Posttraumatic stress disorder: Scientific and professional dimensions. Academic press. doi:10.1016/B978-0-12-374462-3.X0001-9

Le Brocque, R. M., Hendrikz, J., & Kenardy, J. A. (2009). The course of posttraumatic stress in children: Examination of recovery trajectories following traumatic injury. Journal of Pediatric Psychology, 35(6), 637-645. https://doi.org/10.1093/jpepsy/jsp050

© University of Glasgow
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Post-Traumatic Stress Disorder (PTSD) in the Global Context

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