Trauma trigger

A '''trauma trigger''' is a [[Stimulus (psychology)|psychological stimulus]] that prompts involuntary recall of a previous [[psychological trauma|traumatic experience]]. The stimulus itself need not be frightening or traumatic and may be only indirectly or superficially reminiscent of an earlier traumatic incident, such as a scent or a piece of clothing.{{cite web | title = Post traumatic stress disorder (PTSD) | url = http://www.vvaa.org.au/ptsd.htm | publisher = Vietnam Veterans Association of Australia | date = 2015 | access-date = 4 February 2016 }} Triggers can be subtle, individual, and difficult for others to predict.{{cite journal |last1=van der Kolk |first1=Bessel A. |title=The Body Keeps the Score: Memory and the Evolving Psychobiology of Post traumatic Stress |journal=Harvard Review of Psychiatry |date=January 1994 |volume=1 |issue=5 |pages=253–265 |doi=10.3109/10673229409017088 |pmid=9384857 |s2cid=23677122 }}{{Cite book |last=Dalton |first=Derek |title=Scholarship of Teaching and Learning in Criminology |date=2020 |others=Darren Palmer |isbn=978-3-030-35158-8 |location=Cham, Switzerland |publisher=Palgrave Macmillan |chapter=Trigger Warnings in Criminology Teaching Contexts: Some Reflections Based on Ten Years of Teaching a Sensitive Topic |oclc=1145574118}} A trauma trigger may also be called a '''trauma stimulus''', a '''trauma [[stressor]]''' or a '''trauma reminder'''.{{cite journal |last1=Fagan |first1=Nancy |last2=Freme |first2=Kathleen |title=Confronting posttraumatic stress disorder |journal=Nursing |date=February 2004 |volume=34 |issue=2 |pages=52–53 |doi=10.1097/00152193-200402000-00048 |pmid=14758331 |s2cid=33910036 }}{{cite book |last1=Foa |first1=Edna B. |last2=Keane |first2=Terence M. |last3=Friedman |first3=Matthew J. |last4=Cohen |first4=Judith A. |title=Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies |date=2008 |publisher=Guilford Press |isbn=978-1-60623-792-2 |page=274 }}

A '''trauma trigger''' is a [[Stimulus (psychology)|psychological stimulus]] that prompts involuntary recall of a previous [[psychological trauma|traumatic experience]]. The stimulus itself need not be frightening or traumatic and may be only indirectly or superficially reminiscent of an earlier traumatic incident, such as a scent or a piece of clothing.{{cite web | title = Post traumatic stress disorder (PTSD) | url = http://www.vvaa.org.au/ptsd.htm | publisher = Vietnam Veterans Association of Australia | date = 2015 | access-date = 4 February 2016 }} Triggers can be subtle, individual, and difficult for others to predict.{{cite journal |last1=van der Kolk |first1=Bessel A. |title=The Body Keeps the Score: Memory and the Evolving Psychobiology of Post traumatic Stress |journal=Harvard Review of Psychiatry |date=January 1994 |volume=1 |issue=5 |pages=253–265 |doi=10.3109/10673229409017088 |pmid=9384857 |s2cid=23677122 }}{{Cite book |last=Dalton |first=Derek |title=Scholarship of Teaching and Learning in Criminology |date=2020 |others=Darren Palmer |isbn=978-3-030-35158-8 |location=Cham, Switzerland |publisher=Palgrave Macmillan |chapter=Trigger Warnings in Criminology Teaching Contexts: Some Reflections Based on Ten Years of Teaching a Sensitive Topic |oclc=1145574118}} A trauma trigger may also be called a '''trauma stimulus''', a '''trauma [[stressor]]''' or a '''trauma reminder'''.{{cite journal |last1=Fagan |first1=Nancy |last2=Freme |first2=Kathleen |title=Confronting posttraumatic stress disorder |journal=Nursing |date=February 2004 |volume=34 |issue=2 |pages=52–53 |doi=10.1097/00152193-200402000-00048 |pmid=14758331 |s2cid=33910036 }}{{cite book |last1=Foa |first1=Edna B. |last2=Keane |first2=Terence M. |last3=Friedman |first3=Matthew J. |last4=Cohen |first4=Judith A. |title=Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies |date=2008 |publisher=Guilford Press |isbn=978-1-60623-792-2 |page=274 }}

The process of connecting a traumatic experience to a trauma trigger is called '''traumatic coupling'''.{{cite book |last1=Goulston |first1=Mark |title=Post-Traumatic Stress Disorder For Dummies |date=2011 |publisher=John Wiley & Sons |isbn=978-1-118-05090-3 |page=40 |url=https://books.google.com/books?id=BlHgzUBOzbEC&pg=PA40 }} When trauma is "triggered", the involuntary response goes far beyond feeling uncomfortable and can feel overwhelming and uncontrollable, such as a [[panic attack]], a [[Flashback (psychology)|flashback]], or a strong impulse to flee to a safe place.{{Cite book |last=Taylor |first=Holly |date=2017 |chapter=Contagious Speech: Mediating the Eating Disorder Panic Through Trigger Warnings |editor=Emily Knox |title=Trigger Warnings: History, Theory, Context |isbn=978-1-4422-7371-9 |location=Lanham, Maryland |publisher=Rowman & Littlefield |pages=27–30 |oclc=973920466}}{{Cite book |last1=Hilderbrand |first1=Lucas |chapter-url=https://books.google.com/books?id=zN7SDwAAQBAJ&dq=trauma+trigger+%22being+uncomfortable%22&pg=PT724 |title=The Routledge Companion to Media and Risk |last2=Sarkar |first2=Bhaskar |year=2020 |publisher=Routledge |isbn=978-1-317-26822-2 |editor-last=Ghosh |editor-first=Bishnupriya |language=en |chapter=Trigger Warnings and the Disciplining of Cinema and Media Pedagogy}} Avoiding a trauma trigger, and therefore the potentially extreme reaction it provokes, is a common behavioral symptom of [[posttraumatic stress disorder]] (PTSD) and [[post-traumatic embitterment disorder]] (PTED), a treatable and usually temporary condition in which people sometimes experience overwhelming emotional or physical symptoms when something reminds them of, or "triggers" the [[traumatic memories|memory of, a traumatic event]]. Long-term avoidance of triggers increases the likelihood that the affected person will develop a disabling level of PTSD.{{cite book |last1=Lahad |first1=Mooli |last2=Doron |first2=Miki |title=Protocol for Treatment of Post Traumatic Stress Disorder: See FAR CBT Model: Beyond Cognitive Behavior Therapy |date=2010 |publisher=IOS Press |isbn=978-1-60750-574-7 |page=18 |url=https://books.google.com/books?id=4iFlPSVxmqcC&pg=PA18 }} Identifying and addressing trauma triggers is an important part of treating PTSD.

The process of connecting a traumatic experience to a trauma trigger is called '''traumatic coupling'''.{{cite book |last1=Goulston |first1=Mark |title=Post-Traumatic Stress Disorder For Dummies |date=2011 |publisher=John Wiley & Sons |isbn=978-1-118-05090-3 |page=40 |url=https://books.google.com/books?id=BlHgzUBOzbEC&pg=PA40 }} When trauma is "triggered", the involuntary response goes far beyond feeling uncomfortable and can feel overwhelming and uncontrollable, such as a [[panic attack]], a [[Flashback (psychology)|flashback]], or a strong impulse to flee to a safe place.>{{Cite journal|last1=Laguardia|first1=Francesca|last2=Michalsen|first2=Venezia|last3=Rider-Milkovich|first3=Holly|date=2017|title=Trigger Warnings: From Panic to Data|journal=[[Journal of Legal Education]]|volume=66|issue=4|pages=882–903|jstor=26453524}}</ref>{{Cite book |last=Taylor |first=Holly |date=2017 |chapter=Contagious Speech: Mediating the Eating Disorder Panic Through Trigger Warnings |editor=Emily Knox |title=Trigger Warnings: History, Theory, Context |isbn=978-1-4422-7371-9 |location=Lanham, Maryland |publisher=Rowman & Littlefield |pages=27–30 |oclc=973920466}}{{Cite book |last1=Hilderbrand |first1=Lucas |chapter-url=https://books.google.com/books?id=zN7SDwAAQBAJ&dq=trauma+trigger+%22being+uncomfortable%22&pg=PT724 |title=The Routledge Companion to Media and Risk |last2=Sarkar |first2=Bhaskar |year=2020 |publisher=Routledge |isbn=978-1-317-26822-2 |editor-last=Ghosh |editor-first=Bishnupriya |language=en |chapter=Trigger Warnings and the Disciplining of Cinema and Media Pedagogy}} Avoiding a trauma trigger, and therefore the potentially extreme reaction it provokes, is a common behavioral symptom of [[posttraumatic stress disorder]] (PTSD) and [[post-traumatic embitterment disorder]] (PTED), a treatable and usually temporary condition in which people sometimes experience overwhelming emotional or physical symptoms when something reminds them of, or "triggers" the [[traumatic memories|memory of, a traumatic event]]. Long-term avoidance of triggers increases the likelihood that the affected person will develop a disabling level of PTSD.{{cite book |last1=Lahad |first1=Mooli |last2=Doron |first2=Miki |title=Protocol for Treatment of Post Traumatic Stress Disorder: See FAR CBT Model: Beyond Cognitive Behavior Therapy |date=2010 |publisher=IOS Press |isbn=978-1-60750-574-7 |page=18 |url=https://books.google.com/books?id=4iFlPSVxmqcC&pg=PA18 }} Identifying and addressing trauma triggers is an important part of treating PTSD.

A ''[[#Trigger warnings|trigger warning]]'' is a message presented to an audience about the contents of a piece of media, to warn them that it contains potentially distressing content. A more generic term, which is not directly focused on PTSD, is ''content warning''.

A ''[[#Trigger warnings|trigger warning]]'' is a message presented to an audience about the contents of a piece of media, to warn them that it contains potentially distressing content. A more generic term, which is not directly focused on PTSD, is ''content warning''.

==Triggers==

==Triggers==

The trigger can be anything that provokes fear or distressing memories in the affected person, and which the affected person associates with a previous traumatic experience. Just as [[Psychological trauma|trauma]] is not merely an unpleasant or adverse experience, a trauma trigger is not merely something that makes a person feel uncomfortable or offended.{{Cite book |last=Greenberg |first=Tamara McClintock |url=https://books.google.com/books?id=pzn1DwAAQBAJ&dq=ptsd+trigger+uncomfortable&pg=PA5 |title=Treating Complex Trauma: Combined Theories and Methods |year=2020 |publisher=Springer Nature |isbn=978-3-030-45285-8 |page=5 |language=en}} Some common triggers are:

Trauma triggers have been recognized by medical professionals since the 19th century. The trigger can be anything that provokes fear or distressing memories in the affected person, and which the affected person associates with a previous traumatic experience. Just as [[Psychological trauma|trauma]] is not merely an unpleasant or adverse experience, a trauma trigger is not merely something that makes a person feel uncomfortable or offended.{{Cite book |last=Greenberg |first=Tamara McClintock |url=https://books.google.com/books?id=pzn1DwAAQBAJ&dq=ptsd+trigger+uncomfortable&pg=PA5 |title=Treating Complex Trauma: Combined Theories and Methods |year=2020 |publisher=Springer Nature |isbn=978-3-030-45285-8 |page=5 |language=en}} Some common triggers are:

* a particular smell – such as freshly mown grass, the fragrance of an [[aftershave]] product or [[perfume]]. The sense of smell, [[olfaction]], may be more closely connected to traumatic reminders than other sensory experiences.{{cite journal |last1=Vermetten |first1=Eric |last2=Bremner |first2=J. Douglas |title=Olfaction as a Traumatic Reminder in Posttraumatic Stress Disorder: Case Reports and Review |journal=The Journal of Clinical Psychiatry |date=15 February 2003 |volume=64 |issue=2 |pages=202–207 |doi=10.4088/jcp.v64n0214 |pmid=12633130 }}

* a particular smell – such as freshly mown grass, the fragrance of an [[aftershave]] product or [[perfume]]. The sense of smell, [[olfaction]], may be more closely connected to traumatic reminders than other sensory experiences.{{cite journal |last1=Vermetten |first1=Eric |last2=Bremner |first2=J. Douglas |title=Olfaction as a Traumatic Reminder in Posttraumatic Stress Disorder: Case Reports and Review |journal=The Journal of Clinical Psychiatry |date=15 February 2003 |volume=64 |issue=2 |pages=202–207 |doi=10.4088/jcp.v64n0214 |pmid=12633130 }}

Although the subject has generated political controversy, research suggests that trigger warnings are neither harmful nor especially helpful. Among people without traumatic experiences, "trigger warnings did not affect anxiety responses to potentially distressing material in general."{{cite journal |last1=Bellet |first1=Benjamin W. |last2=Jones |first2=Payton J. |last3=McNally |first3=Richard J. |date=December 2018 |title=Trigger warning: Empirical evidence ahead |journal=Journal of Behavior Therapy and Experimental Psychiatry |volume=61 |pages=134–141 |doi=10.1016/j.jbtep.2018.07.002 |pmid=30077703 |s2cid=51930369}} Furthermore, studies disagree on whether trigger warnings cause transient increases in anxiety in those without traumatic experiences.{{cite journal |last1=Bellet |first1=Benjamin W. |last2=Jones |first2=Payton J. |last3=Meyersburg |first3=Cynthia A. |last4=Brenneman |first4=Miranda M. |last5=Morehead |first5=Kaitlin E. |last6=McNally |first6=Richard J. |date=December 2020 |title=Trigger warnings and resilience in college students: A preregistered replication and extension. |journal=Journal of Experimental Psychology: Applied |volume=26 |issue=4 |pages=717–723 |doi=10.1037/xap0000270 |pmid=32281813 |s2cid=149505821}}{{cite journal |last1=Sanson |first1=Mevagh |last2=Strange |first2=Deryn |last3=Garry |first3=Maryanne |date=July 2019 |title=Trigger Warnings Are Trivially Helpful at Reducing Negative Affect, Intrusive Thoughts, and Avoidance |journal=Clinical Psychological Science |volume=7 |issue=4 |pages=778–793 |doi=10.1177/2167702619827018 |s2cid=150545454}} For participants who self-reported a posttraumatic stress disorder (PTSD) diagnosis, or for participants who qualified for probable PTSD, trigger warnings had little [[Statistical significance|statistically significant]] effect.{{cite journal |last1=Jones |first1=Payton J. |last2=Bellet |first2=Benjamin W. |last3=McNally |first3=Richard J. |date=September 2020 |title=Helping or Harming? The Effect of Trigger Warnings on Individuals With Trauma Histories |journal=Clinical Psychological Science |volume=8 |issue=5 |pages=905–917 |doi=10.1177/2167702620921341 |doi-access=free}} [[Effect size]]s on feelings of avoidance, decreased resilience, or other negative outcomes have been "trivial" in controlled research environments.

Although the subject has generated political controversy, research suggests that trigger warnings are neither harmful nor especially helpful. Among people without traumatic experiences, "trigger warnings did not affect anxiety responses to potentially distressing material in general."{{cite journal |last1=Bellet |first1=Benjamin W. |last2=Jones |first2=Payton J. |last3=McNally |first3=Richard J. |date=December 2018 |title=Trigger warning: Empirical evidence ahead |journal=Journal of Behavior Therapy and Experimental Psychiatry |volume=61 |pages=134–141 |doi=10.1016/j.jbtep.2018.07.002 |pmid=30077703 |s2cid=51930369}} Furthermore, studies disagree on whether trigger warnings cause transient increases in anxiety in those without traumatic experiences.{{cite journal |last1=Bellet |first1=Benjamin W. |last2=Jones |first2=Payton J. |last3=Meyersburg |first3=Cynthia A. |last4=Brenneman |first4=Miranda M. |last5=Morehead |first5=Kaitlin E. |last6=McNally |first6=Richard J. |date=December 2020 |title=Trigger warnings and resilience in college students: A preregistered replication and extension. |journal=Journal of Experimental Psychology: Applied |volume=26 |issue=4 |pages=717–723 |doi=10.1037/xap0000270 |pmid=32281813 |s2cid=149505821}}{{cite journal |last1=Sanson |first1=Mevagh |last2=Strange |first2=Deryn |last3=Garry |first3=Maryanne |date=July 2019 |title=Trigger Warnings Are Trivially Helpful at Reducing Negative Affect, Intrusive Thoughts, and Avoidance |journal=Clinical Psychological Science |volume=7 |issue=4 |pages=778–793 |doi=10.1177/2167702619827018 |s2cid=150545454}} For participants who self-reported a posttraumatic stress disorder (PTSD) diagnosis, or for participants who qualified for probable PTSD, trigger warnings had little [[Statistical significance|statistically significant]] effect.{{cite journal |last1=Jones |first1=Payton J. |last2=Bellet |first2=Benjamin W. |last3=McNally |first3=Richard J. |date=September 2020 |title=Helping or Harming? The Effect of Trigger Warnings on Individuals With Trauma Histories |journal=Clinical Psychological Science |volume=8 |issue=5 |pages=905–917 |doi=10.1177/2167702620921341 |doi-access=free}} [[Effect size]]s on feelings of avoidance, decreased resilience, or other negative outcomes have been "trivial" in controlled research environments.

While trigger warnings have garnered significant debate, few studies have investigated how students typically respond to potentially triggering material. In a 2021 study, 355 undergraduate students from four universities read a passage describing incidents of both physical and sexual assault. Longitudinal measures of subjective distress, PTSD symptoms, and emotional reactivity were measured. Greater than 96% of participants read the triggering passage even when given a non-triggering alternative to read. Of those who read the triggering passage, those with triggering traumas did not report more distress although those with higher PTSD scores did. Two weeks later, those with trigger traumas and/or PTSD did not report an increase in trauma symptoms as a result of reading the triggering passage. Moreover, students with relevant traumas do not avoid triggering material and the effects appear to be brief. Also, students with PTSD do not report an exacerbation of symptoms two weeks later as a function of reading the passage.{{cite journal |last1=Kimble |first1=Matthew |last2=Flack |first2=William |last3=Koide |first3=Jennifer |last4=Bennion |first4=Kelly |last5=Brenneman |first5=Miranda |last6=Meyersburg |first6=Cynthia |title=Student reactions to traumatic material in literature: Implications for trigger warnings |journal=PLOS ONE |date=25 March 2021 |volume=16 |issue=3 |article-number=e0247579 |doi=10.1371/journal.pone.0247579 |pmid=33765044 |pmc=7993791 |bibcode=2021PLoSO..1647579K |doi-access=free }}

While trigger warnings have garnered significant debate, few studies have investigated how students typically respond to potentially triggering material. In a 2021 study, 355 undergraduate students from four universities read a passage describing incidents of both physical and sexual assault. Longitudinal measures of subjective distress, PTSD symptoms, and emotional reactivity were measured. Greater than 96% of participants read the triggering passage even when given a non-triggering alternative to read. Of those who read the triggering passage, those with triggering traumas did not report more distress although those with higher PTSD scores did. Two weeks later, those with trigger traumas and/or PTSD did not report an increase in trauma symptoms as a result of reading the triggering passage. Moreover, students with relevant traumas do not avoid triggering material and the effects appear to be brief, and students with PTSD do not report an exacerbation of symptoms two weeks later as a function of reading the passage.{{cite journal |last1=Kimble |first1=Matthew |last2=Flack |first2=William |last3=Koide |first3=Jennifer |last4=Bennion |first4=Kelly |last5=Brenneman |first5=Miranda |last6=Meyersburg |first6=Cynthia |title=Student reactions to traumatic material in literature: Implications for trigger warnings |journal=PLOS ONE |date=25 March 2021 |volume=16 |issue=3 |article-number=e0247579 |doi=10.1371/journal.pone.0247579 |pmid=33765044 |pmc=7993791 |bibcode=2021PLoSO..1647579K |doi-access=free }}

==History==

{{Expand section|date=August 2025}}

Trauma triggers have been recognized by medical professionals since the 19th century.{{Cite journal|last1=Laguardia|first1=Francesca|last2=Michalsen|first2=Venezia|last3=Rider-Milkovich|first3=Holly|date=2017|title=Trigger Warnings: From Panic to Data|journal=[[Journal of Legal Education]]|volume=66|issue=4|pages=882–903|jstor=26453524}}

==See also==

==See also==