How Adults from the General Population Define Trauma: Highlighting the Need for a Broader and More Inclusive Understanding

Background and Purpose: An increasing awareness of trauma and its consequences exists within society. Effective trauma-specific treatments exist. However, people may only seek treatment if they recognize their experiences as traumatic and the catalyst for their current symptoms and/or problems. The way that trauma is defined can either encourage or deter people from making these personal connections. Furthermore, assessing for PTSD and other sequelae of trauma is predicated on a shared understanding of the definition of trauma between clinicians and their clients. As such, it is important to understand how people conceptualize what constitutes a traumatic exposure, since these experiences may lead them to seek clinical services. While existing research has examined narratives and expressions of trauma, little is known about how people define and conceptualize the term “trauma.” Our study addresses this gap by analyzing definitions of “trauma” provided by adults from the general population.

Method: We analyzed qualitative data from a larger online, mixed-methods, cross-sectional study of adversity and sexual well-being. Our analytic sample (N=257) consisted of adults (mean age 41 years old, SD=11.94) from the United States who primarily identified as white (85.2%), with Black (7.8%), Asian (6.6%), and Latinx (6.2%) identities being the next most common. Slightly more than half of respondents identified as female (58.4%), about a third (34.2%) had earned their bachelor’s degree, and a majority reported being straight (89.9%). We conducted a qualitative thematic analysis of respondents’ free-form responses to the question: “What does the word ‘trauma’ mean to you?” The first and the third authors independently engaged in open manual coding to identify codes and then higher-order themes. Initial agreement rates ranged between 61%-77%, and all discrepancies were resolved via the facilitation of the second author, who served as a content expert throughout the iterative analysis process.

Results: Six main themes emerged: event, reaction, both-event emphasized, both-reaction emphasized, long-lasting impact, and injury. The majority of respondents (70.4%, n=181) provided definitions with a primary focus on traumatic events, as opposed to traumatic reactions (20.2%, n=52); a pattern that was maintained when responses were considered alongside proclamation of their long-lasting impact. Yet, of the respondents whose definitions centered around the themes event or both-event emphasized, almost all (92.8%, n=168) provided an incongruous description with the DSM-5 PTSD diagnostic Criterion A.

Conclusions and Implications: While most respondents in our study provided free-form definitions of trauma focused on events, these events would not be considered traumatic for diagnostic purposes. These results align with previous work demonstrating that PTSD Criterion A may miss the mark for many peoples’ own ideas and experiences of trauma. Being able to recognize and understand one’s past experiences and subsequent reactions as traumatic can yield notable therapeutic benefits for well-being. However, people are unlikely to engage in trauma-focused care if they do not consider themselves trauma-exposed. Our findings underscore benefits of having a more inclusive definition of trauma that aligns with people’s perceptions. Future work should analyze free-form trauma definitions among more diverse, nationally representative samples of respondents from the general population.