Contemporary psychopathology devotes substantial attention to the mechanisms and consequences of individual traumatization. The DSM-IV category posttraumatic stress disorder (PTSD) defines trauma as follows: A. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others and the person’s response involved intense fear, helplessness, or horror. As a consequence, B. The traumatic event is persistently re-experienced in the following ways: (1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions; (2) recurrent distressing dreams of the event; (3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated); (4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event; (5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma). D. Persistent symptoms of increased arousal (not present before the trauma) such as: difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, hypervigilance, or exaggerated startle response
The aftermath of trauma has been traced in neural mechanisms of the brain. According to Perry (1999), involuntary ‘flashback’ remembering originates in the brainstem and midbrain region and limbic system. Intensive or repeated stimulation of these systems as a result of trauma radically changes brain functioning: higher
level cortical systems of external or internal alarm get switched off and emotional-, motor-, and state memory predominate.