Post-traumatic stress disorder: Evolving conceptualization and evidence, and future research directions
This paper reviews the evolving concepts of PTSD, complex PTSD, treatment strategies including EMDR therapy, and interventions across time-limited settings and cultural contexts.
Article Abstract
“The understanding of responses to traumatic events has been greatly influenced by the introduction of the diagnosis of post-traumatic stress disorder (PTSD). In this paper we review the initial versions of the diagnostic criteria for this condition and the associated epidemiological findings, including sociocultural differences. We consider evidence for post-traumatic reactions occurring in multiple contexts not previously defined as traumatic, and the implications that these observations have for the diagnosis. More recent developments such as the DSM-5 dissociative subtype and the ICD-11 diagnosis of complex PTSD are reviewed, adding to evidence that there are several distinct PTSD phenotypes. We describe the psychological foundations of PTSD, involving disturbances to memory as well as to identity. A broader focus on identity may be able to accommodate group and communal influences on the experience of trauma and PTSD, as well as the impact of resource loss. We then summarize current evidence concerning the biological foundations of PTSD, with a particular focus on genetic and neuroimaging studies. Whereas progress in prevention has been disappointing, there is now an extensive evidence supporting the efficacy of a variety of psychological treatments for established PTSD, including trauma-focused interventions – such as trauma-focused cognitive behavior therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) – and non-trauma-focused therapies, which also include some emerging identity-based approaches such as present-centered and compassion-focused therapies. Additionally, there are promising interventions that are neither psychological nor pharmacological, or that combine a pharmacological and a psychological approach, such as 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. We review advances in the priority areas of adapting interventions in resource-limited settings and across cultural contexts, and of community-based approaches. We conclude by identifying future directions for work on trauma and mental health.”
—Description from publisher
Article Access
Open Access
Brewin, C. R., Atwoli, L., Bisson, J. I., Galea, S., Koenen, K., & Lewis-Fernandez, R. (2025). Post-traumatic stress disorder: Evolving conceptualization and evidence, and future research directions. World Psychiatry, 24(1), 52-80. https://doi.org/10.1002/wps.21269
Date
January 15, 2025
Creator(s)
Chris R. Brewin, Lukoye Atwoli, Jonathan I. Bisson
Contributor(s)
Sandro Galea, Karestan Koenen, Roberto Lewis-Fernández
Topics
Complex Trauma/C-PTSD, PTSD
Practice & Methods
Efficacy
Extent
29 pages
Publisher
World Psychiatric Association
Rights
© 2025 World Psychiatric Association.
APA Citation
Brewin, C. R., Atwoli, L., Bisson, J. I., Galea, S., Koenen, K., & Lewis-Fernandez, R. (2025). Post-traumatic stress disorder: Evolving conceptualization and evidence, and future research directions. World Psychiatry, 24(1), 52-80. https://doi.org/10.1002/wps.21269
Audience
EMDR Therapists
Language
English
Content Type
Article, Peer-Reviewed
Access Type
External Resource, Open Access