The impact of trauma and how to intervene: a narrative review of psychotraumatology over the past 15 years

Miranda Olff; Irma Hein; Ananda B Amstadter; Cherie Armour; Marianne Skogbrott Birkeland; Eric Bui; Marylene Cloitre; Anke Ehlers; Julian D Ford; Talya Greene; Maj Hansen; Nathaniel G Harnett; Debra Kaminer; Catrin Lewis; Alessandra Minelli; Barbara Niles; Nicole R Nugent; Neil Roberts; Matthew Price; Anthony N Reffi; Soraya Seedat; Antonia V Seligowski; Anka A Vujanovic

doi:10.1080/20008066.2025.2458406

The impact of trauma and how to intervene: a narrative review of psychotraumatology over the past 15 years

Eur J Psychotraumatol. 2025 Dec;16(1):2458406. doi: 10.1080/20008066.2025.2458406. Epub 2025 Feb 6.

Authors

Miranda Olff^{1

2}, Irma Hein^{1

3}, Ananda B Amstadter⁴, Cherie Armour⁵, Marianne Skogbrott Birkeland⁶, Eric Bui^{7

8}, Marylene Cloitre^{9

10}, Anke Ehlers¹¹, Julian D Ford¹², Talya Greene¹³, Maj Hansen¹⁴, Nathaniel G Harnett^{15

16}, Debra Kaminer¹⁷, Catrin Lewis¹⁸, Alessandra Minelli^{19

20}, Barbara Niles^{21

22}, Nicole R Nugent²³, Neil Roberts^{24

25}, Matthew Price²⁶, Anthony N Reffi^{27

28}, Soraya Seedat²⁹, Antonia V Seligowski³⁰, Anka A Vujanovic³¹

Affiliations

¹ Department of Psychiatry, Amsterdam UMC location University of Amsterdam, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam, The Netherlands.
² ARQ National Psychotrauma Centre, Diemen, The Netherlands.
³ Levvel, Amsterdam, The Netherlands.
⁴ Departments of Psychiatry, Psychology, & Human and Molecular Genetics, Virginia Commonwealth University, Richmond, USA.
⁵ Trauma and Mental Health Research Centre, School of Psychology, Queens University Belfast, Belfast, UK.
⁶ Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
⁷ Caen University Hospital, University of Caen Normandy, Caen, France.
⁸ Massachusetts General Hospital, Boston, MA, USA.
⁹ National Center for PTSD, Palo Alto, CA, USA.
¹⁰ New York University, Silver School of Social Work, New York, NY, USA.
¹¹ Department of Experimental Psychology, University of Oxford, Oxford, UK.
¹² Department of Psychiatry, University of Connecticut Health Center, Farmington, USA.
¹³ Clinical, Educational and Health Psychology, University College London, London, UK.
¹⁴ THRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark.
¹⁵ Neurobiology of Affective and Traumatic Experiences Laboratory, McLean Hospital, Belmont, USA.
¹⁶ Harvard Medical School, Boston, MA, USA.
¹⁷ Department of Psychology, University of Cape Town, Cape Town, South Africa.
¹⁸ National Centre for Mental Health (NCMH), Cardiff University, Cardiff, UK.
¹⁹ Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
²⁰ Genetics Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
²¹ Boston University Chobonian and Avedisian School of Medicine, USA.
²² National Center for PTSD Behavioral Science Division at VA Boston Healthcare System, Boston, MA, USA.
²³ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence RI, USA.
²⁴ Psychology & Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK.
²⁵ Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
²⁶ University of Vermont, Burlington, VT, USA.
²⁷ Sleep Disorders & Research Center, Henry Ford Health, Detroit, MI, USA.
²⁸ Department of Surgery, Division of Acute Care Surgery, Henry Ford Health, Detroit, MI, USA.
²⁹ SAMRC/SU Genomics of Brain Disorders Research Unit, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
³⁰ Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, USA.
³¹ Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA.

Abstract
in English, Spanish

To mark 15 years of the European Journal of Psychotraumatology, editors reviewed the past 15-year years of research on trauma exposure and its consequences, as well as developments in (early) psychological, pharmacological and complementary interventions. In all sections of this paper, we provide perspectives on sex/gender aspects, life course trends, and cross-cultural/global and systemic societal contexts. Globally, the majority of people experience stressful events that may be characterized as traumatic. However, definitions of what is traumatic are not necessarily straightforward or universal. Traumatic events may have a wide range of transdiagnostic mental and physical health consequences, not limited to posttraumatic stress disorder (PTSD). Research on genetic, molecular, and neurobiological influences show promise for further understanding underlying risk and resilience for trauma-related consequences. Symptom presentation, prevalence, and course, in response to traumatic experiences, differ depending on individuals' age and developmental phase, sex/gender, sociocultural and environmental contexts, and systemic socio-political forces. Early interventions have the potential to prevent acute posttraumatic stress reactions from escalating to a PTSD diagnosis whether delivered in the golden hours or weeks after trauma. However, research on prevention is still scarce compared to treatment research where several evidence-based psychological, pharmacological and complementary/ integrative interventions exist, and novel forms of delivery have become available. Here, we focus on how best to address the range of negative health outcomes following trauma, how to serve individuals across the age spectrum, including the very young and old, and include considerations of sex/gender, ethnicity, and culture in diverse contexts, beyond Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries. We conclude with providing directions for future research aimed at improving the well-being of all people impacted by trauma around the world. The 15 years EJPT webinar provides a 90-minute summary of this paper and can be downloaded here [http://bit.ly/4jdtx6k].

Para marcar los 15 años de la Revista Europea de Psicotraumatología, los editores revisaron los últimos 15 años de investigación acerca de la exposición a trauma y sus consecuencias, así como el desarrollo en las intervenciones (tempranas) psicológicas, farmacológicas y complementarias. En todas las secciones de este artículo, proporcionamos perspectivas en aspectos de sexo/género, tendencias durante el curso de la vida y contextos sociales interculturales/globales y sistémicos. Mundialmente, la mayoría de las personas experimenta eventos estresantes que se pueden caracterizar como traumáticos. Sin embargo, las definiciones de qué es traumático no necesariamente son sencillas o universales. Los eventos traumáticos pueden tener un amplio rango de consecuencias mentales y físicas transdiagnósticas, no limitadas al trastorno de estrés postraumático (TEPT). Las investigaciones en las influencias genéticas, moleculares y neurobiológicas son prometedoras para comprender mejor el riesgo y la resiliencia subyacentes ante las consecuencias relacionadas con el trauma. La presentación, prevalencia y evolución de los síntomas, en respuesta a experiencias traumáticas, difieren dependiendo de la edad de los individuos y la fase de su desarrollo, sexo/género, contextos socioculturales y ambientales y las fuerzas sociopolíticas sistémicas. Las intervenciones tempranas tienen el potencial de prevenir que las reacciones de estrés postraumáticas agudo se intensifiquen hasta llegar a un diagnóstico de TEPT, ya sea que se realicen en las “horas doradas” o semanas posteriores al trauma. Sin embargo, la investigación en la prevención es aún escasa comparada con la investigación sobre tratamientos donde existen varias intervenciones psicológicas, farmacológicas y complementarias/integrativas basadas en la evidencia, y se ha puesto a disposición novedosas formas de aplicación. En este artículo, nos centramos en cuál es la mejor forma de abordar la variedad de resultados negativos después del trauma, cómo atender a las personas de todo el espectro de edades, incluidos los muy jóvenes y muy mayores e incorporamos consideraciones de sexo/género, etnicidad y contextos culturales diversos, más allá de los países Occidentales, Educados, Industrializados, Ricos y Democráticos (WEIRD por sus siglas en inglés). Concluimos proporcionando orientaciones para futuras investigaciones destinadas a mejorar el bienestar de todas las personas afectadas por trauma alrededor del mundo.

Keywords: PTSD; TEPT; Trauma; a lo largo de la vida; biopsicosocial; biopsychosocial; global context; lifespan; mundial contexto; prevención; prevention; resilience; resiliencia; sex/gender; sexo/genero; transdiagnostic; transdiagnóstico; tratamiento; treatment.

Plain language summary

Defining trauma is complex and multifaceted with survivors’ subjective interpretation of an experience being more important than the objective characteristics of an event. Research needs to consider sex/gender, age, and geographical and cultural contexts in defining trauma.Trauma may have multiple, often comorbid, mental and physical health outcomes, calling for transdiagnostic screening of trauma survivors. Assessments need to be improved to capture sex/gender differences, young and older trauma survivors and cultural contexts.Several (innovative) evidence-based interventions are available for prevention and treatment of trauma outcomes, but more research is needed on if and how to adapt these for optimal efficacy across sex/genders, the life span and local cultural contexts.

Publication types

Editorial
Review

MeSH terms

Humans
Stress Disorders, Post-Traumatic* / therapy

Grants and funding

K23 MH134032/MH/NIMH NIH HHS/United States

Abstract in English, Spanish

Plain language summary

Publication types

MeSH terms

Grants and funding

Abstract
in English, Spanish