Conceptual Models Of Stress

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Traumatic stress

Traumatic stress is the physical and emotional response to experiences that threaten someone's physical, emotional, mental and spiritual well-being (or the well-being of someone close to them). Examples of such experiences can be the loss of parent or caregiver, exposure to community or domestic violence, child abuse or neglect, natural disasters, war and refugee experiences, exposure to toxic stress such as racism, poverty, and other forms of adversity (as described below). These experiences can overwhelm internal and external capacity to cope, and have a profound impact on physiological, cognitive, emotional and behavioral functions.

A 2009 Department of Justice study [2] found that 60% of children in the U.S. have been exposed directly or indirectly some form of violence, including 25% who had been exposed to violence in the home. According to the Children's Defense Fund, 16.1 million children, or 1 in 5 children in the United States, were living in poverty [1].

One consequence of exposure to traumatic experiences is the development of post-traumatic stress disorder (PTSD). National Comorbidity Survey, using the clinical definition of post-traumatic stress disorder, estimated the lifetime prevalence for PTSD among all American adults to be 6.8%, with another study finding the lifetime prevalence of PTSD to be 7.8% in the general population (with women being twice as likely to experience PTSD at 10.4%, than men at 5%) [5]. While not all of those who experience trauma develop PTSD, PTSD is higher among those who have experienced trauma and the likelihood for developing PTSD increases due to a number of factors, e.g. experiencing multiple traumatic events, traumatic events related to people who are close to you (such as witnessing the death of a sibling or being abused by a caregiver), and the level of support received following the event [4].

Toxic stress and adversity

When faced with a threat, the human body has adapted over millions of years to undergo a stress response aimed at increasing survival. This includes the increase of heart rate, blood pressure, and the release of stress hormones such as cortisol. This image from the Harvard Center on the Developing Child [3] illustrates the three main types of stress responses:
Chart describing the three types of stress response: positive, tolerable, and toxic. Image from Harvard Center on the Developing Child.

A positive stress response is a response to things such as the first day of school or getting an immunization, and is a normal and healthy part of development. A tolerable stress response might be in reaction to something challenging, such as the loss of a loved one or a serious injury, but is temporary and limited in severity due to support and resources (such as positive, stable relationships and high quality mental and physical health care, etc.). Toxic stress, however, is a response to chronic and severe trauma and adversity, such as abuse, neglect, homelessness, and war, and this prolonged and severe activation of the body's stress response can have a damaging and persistent effect on the brain and other organs.

Secondary or vicarious traumatic stress

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Related Topics

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See also:

1. Children's Defense Fund (2012, Sep. 17). Child Poverty in America 2012: National Analysis. Washington, DC: Children's Defense Fund. Retrieved January 16, 2014 from
2. Finkelhor, D., Turner, H., Ormrod, R., Hamby, S., and Kracke, K. 2009. Children's Exposure to Violence: A Comprehensive National Survey. Bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.
3. Harvard Center on the Developing Child (2013).
4. Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of general psychiatry, 52(12), 1048.
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