The Transformation of Post-Traumatic Stress Disorder: From Neurosis to Neurobiology

Lives can be severely disrupted after a momentous negative experience. Particularly potent are unexpected negative events, or “traumas,” such as a near death experience, a severe injury, or being exposed to intense interpersonal violence or a natural disaster. Although most people recover from these traumatic events, many do not, and experience persistent fear, anxiety and/or depression following the event. In the past, these maladaptations after trauma were considered to be a reflection of personal weaknesses and were stigmatized. Now, after 30 years of research, the physiological responses to severe stress and trauma are being increasingly understood, as are the risk factors for a pathological response to trauma. These gains from the study of memory and neurohormonal reactivity and control systems hold forth the promise of improved, biologically-informed, psychotherapeutic and pharmacologic interventions for the prevention and treatment of post-traumatic stress disorder (PTSD) in the future.