A new perspective on trauma
New research by scientists at the UI Faculty of Psychology, published under the title Social trauma and its association with posttraumatic stress disorder and social anxiety disorder, suggests that social trauma, such as bullying or mental violence, could cause posttraumatic stress disorder (PTSD).
There has long been debate over what constitutes trauma and what impact it has on other experiences. One approach, for example in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, defines trauma as a specific event, such as sexual violence or a natural disaster. "These are events that can cause symptoms of PTSD, such as intrusive memories of the experience, always being on guard for danger, and avoiding people or places that remind you of what happened. However, it is not clear what it is about an event that causes this response and the debate is still unresolved," says Andri Steinþór.
Social trauma, posttraumatic stress disorder and social anxiety disorder
Andri Steinþór and his colleagues have attempted to defined trauma in terms of threat, with reference to the evolutionary history of humans. "Hitherto, it has mainly been threats to life that are identified in trauma research. But we believe other kinds of threat may play a role, especially what we have referred to as social threat," says Andri Steinþór.
Andri Steinþór and his colleagues believe that rejection and humiliation represent a social threat, for example when a child or adult experiences severe bullying. "We need to interpret this kind of threat in consideration of our evolutionary history. Man is a social animal, as Aristotle said. Humans have always relied on other humans for security, access to food and mates. Being humiliated and rejected by the group is downright life-threatening, from an evolutionary perspective."
According to Andri Steinþór, social anxiety is common in our species. We are afraid of what other people think of us. When this fear starts having an excessive impact on our wellbeing and activity, for example when someone starts avoiding other people or important events, social anxiety disorder (SAD) may develop. "We believe that there may be various links between PTSD and SAD and in some cases it is the same disorder," says Andri Steinþór.
Around a third of people with SAD diagnosed with PTSD
Andri and his team looked at the prevalence of social trauma (an experience involving significant social threat) and links with PTSD in three groups: people with SAD as a primary diagnosis, people with OCD as a primary diagnosis (clinical control group) and people with no psychiatric diagnoses (control group).
Social trauma was common in all three groups: 82% in the SAD group, 79% in the clinical control group and 63% in the control group. Bullying and mental violence were the most common kinds of social trauma. Around a third of the SAD group were diagnosed with PTSD related to their most severe social trauma, compared to nobody in the control groups. A certain number of participants in the SAD group also appeared to have developed both SAD and PTSD in response to the same social trauma.
With this research, Andri Steinþór and his team present a new perspective on trauma which they believe is more likely to reveal why it can elicit such a severe response in people. They also believe that the idea of social threat could help better explain the relationship between psychiatric disorders such as PTSD and SAD.
Interviewer: Klara Sól Ágústsdóttir, student in Journalism and mass communication.
