Guide
Guide | Reference

31  Predominant Trauma and Stress Prototypes

31.1 Summary

  • Prototypes dominated by trauma-linked intrusions, avoidance, hyperarousal, or dysregulated stress responses.

31.2 Included Prototypes (Guide exemplars)

  • PTSD Pattern Prototype (exemplar).
  • Complex Trauma Pattern Prototype (exemplar).
  • Full catalog appears in the Clean Reference.

31.3 How to Use This Cluster

  • Start with the Atlas entry for trauma-related experiences.
  • Rate the Trauma and Stress Response domain.
  • Apply a prototype label only when it improves communication or documentation.

31.4 Boundary Markers

  • What it is: trauma-linked patterns that persist beyond the event or disrupt function.
  • What it is not: short-term, proportional stress reactions without persistent impairment.

31.5 Common Overlap

  • Anxiety and threat sensitivity.
  • Sleep and arousal dysregulation.
  • Emotion regulation and interpersonal pain.

31.6 PTSD Pattern Prototype (Exemplar)

31.6.1 Summary

  • A pattern of trauma-linked intrusions, avoidance, and hyperarousal that persists and disrupts functioning.

31.6.2 Prototype Features

  • Re-experiencing (memories, flashbacks, nightmares).
  • Avoidance of reminders and emotional numbing.
  • Hypervigilance, startle response, or sleep disruption.

31.6.3 Threshold Guidance

  • Use when trauma-linked symptoms are persistent, recurrent, and impairing.

31.6.4 Expected Domain Profile

  • Trauma and Stress Response: moderate to high.
  • Anxiety and Threat Sensitivity: moderate.
  • Arousal, Sleep, and Circadian Regulation: mild to moderate disruption.

31.6.5 Time-Course and Trajectory

  • Often chronic with trigger-related spikes.
  • May fluctuate with stress exposure.

31.6.6 Differential and Red Flags

  • Acute stress reactions without persistence.
  • Dissociative episodes without trauma linkage.
  • Substance effects or sleep deprivation.

31.6.7 Specifiers

Specifiers: course + contributors + risk, as relevant; see Reference for full.

31.7 Complex Trauma Pattern Prototype (Exemplar)

31.7.1 Summary

  • A pattern of trauma-linked dysregulation with pervasive effects on self-concept, emotion regulation, and relationships.

31.7.2 Prototype Features

  • Chronic trauma history with persistent dysregulation.
  • Emotional numbing or volatility.
  • Relational instability, mistrust, or attachment disruptions.

31.7.3 Threshold Guidance

  • Use when trauma-linked symptoms are pervasive and span multiple domains of function.

31.7.4 Expected Domain Profile

  • Trauma and Stress Response: high.
  • Emotion Regulation and Interpersonal Pain: moderate to high.
  • Mood and Drive Dysregulation: variable.

31.7.5 Time-Course and Trajectory

  • Chronic and pervasive, often with episodic worsening.

31.7.6 Differential and Red Flags

  • Personality dysfunction without trauma linkage.
  • Substance effects or ongoing acute crises.
  • Neurodevelopmental factors affecting regulation.

31.7.7 Specifiers

Specifiers: course + contributors + risk, as relevant; see Reference for full.