Trauma model of mental disorders

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The trauma model of mental disorders, or trauma model of psychopathology, emphasises the effects of physical, sexual and psychological trauma as key causal factors in the development of psychiatric disorders, including depression and anxiety^[1] as well as psychosis,^[2] whether the trauma is experienced in childhood or adulthood. It conceptualises people as having understandable reactions to traumatic events rather than suffering from mental illness.

Trauma models emphasise that traumatic experiences are more common and more significant in terms of aetiology than has often been thought in people diagnosed with mental disorders. Such models have their roots in some psychoanalytic approaches, notably Sigmund Freud's early ideas on childhood sexual abuse and hysteria,^[3] Pierre Janet's work on dissociation, and John Bowlby's attachment theory. There is significant research supporting the linkage between early experiences of chronic maltreatment and severe neglect and later psychological problems.^[4]

In the 1960s trauma models became associated with humanist and anti-psychiatry approaches, particularly in regard to understanding schizophrenia and the role of the family.^[5] Personality disorders have also been a focus, particularly borderline personality disorder, with the role of dissociation and 'freezing responses' (more extreme reactions than fight-flight when someone is terrified and traumatised) thought to have a significant role in the aetiology of psychological disturbance.^[6] Extreme versions of trauma models have implicated the fetal environment and the trauma of being born, but these are not well-supported in the academic literature and have been associated with recovered memory controversies.^{[citation needed]}

People are traumatised by a wide range of people, not just family members. For example, male victims of sexual abuse report being abused in institutional settings (boarding schools, care homes, sports clubs).^[7]

Trauma models thus highlight stressful and traumatic factors in early attachment relations and in the development of mature interpersonal relationships. They are often presented as a counterpoint to psychiatric orthodoxy and inform criticisms of mental health research and practice in that it has become too focused on genetics, neurochemistry and medication.^[8]