Other Specified Trauma- And Stressor-Related Disorder

Other specified trauma- and stressor-related disorder is referred to as “specified” because when it is diagnosed, one of five subtypes is usually selected, each with distinct symptoms. 

Adjustment-like disorders

Adjustment disorders can be categorized as an inability to appropriately respond to a life stressor. They can lead to a variety of symptoms, including anxiety, disrupted sleep, difficulty concentrating, and more.

Two subtypes of other trauma- and stressor-related disorder address adjustment disorder symptoms that do not fit the formal DSM-V criteria for adjustment disorder:

• Adjustment-like disorders with delayed onset of symptoms: With this condition, a patient’s adjustment disorder symptoms do not start until more than three months after the stressor has occurred. 
• Adjustment-like disorders with prolonged duration: With this condition, a patient experiences symptoms of adjustment disorder that persist for more than six months after a stressor has occurred. 

Ataque de nervios

Ataque de nervios is considered a “cultural concept of distress” in the DSM-5, meaning it is a way of describing how a specific cultural group experiences and understands stressful circumstances. Ataque de nervios is experienced by people of Latino descent and directly translates to “attack of the nerves.” 

Ataque de nervios is typically triggered by a stressful event related to a person’s family, such as a death in the family or a family conflict. Symptoms can include emotional turmoil, dissociation, and physical responses like fainting, crying, or trembling. 

Other cultural syndromes

Ataque de nervios is not the only cultural concept of distress that falls under the umbrella of other specified trauma- and stressor-related disorder. Some other cultural syndromes listed in the DSM-5 include:

• Kufungisisa: Directly translated as “thinking too much,” Kufungisisa has a primary symptom of excessive worrying and rumination and is recognized in Zimbabwean, Nigerian, Caribbean, Latin American, East Asian, and Native American cultures.
• Susto: This Latin America cultural syndrome refers to the idea of a traumatic experience causing a person’s soul to leave their body, which results in unpleasant and distressing symptoms similar to those of post-traumatic stress disorder.
• Shenjing shuairuo: A Chinese conception of distress, this syndrome is usually caused by stressors involving personal, professional, academic, or familial failure and results in symptoms like anxiety, fatigue, and neurological pain.

Persistent complex bereavement disorder (PCBD)

This form of other specified trauma- and stressor-related disorder occurs in response to a specific distressing event: the death of someone a person was close to. It is also known as “complicated grief.” Persistent complex bereavement disorder is characterized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) by a disproportionate response to the death, when considering age, culture, religion, a person’s relationship to the deceased, and other factors.

A person with PCBD typically demonstrates symptoms of grief that are more intense and/or last much longer than what would be expected under the circumstances of the death. These symptoms, which can include an inability to accept the person’s death, a fixation on their cause of death, and even hallucinations of the deceased person, can lead to substantial functional impairment.

The only definitive cause of other specified trauma- and stressor-related disorder is exposure to a traumatic event or life stressor. Many people experience trauma and stressors in their lifetime, but not everyone develops symptoms of trauma- and stressor-related disorders. A variety of factors may put certain individuals more at risk for developing disorder symptoms.

Environmental risk factors:

• Prior traumatic experiences, particularly in early childhood
• Lower socioeconomic status
• Childhood family dysfunction
• Severity of trauma/stressor
• Nature of trauma/stressor (risk may be elevated if the experience involved interpersonal violence)
• Lower levels of education
• Divorced or separated parents
• Exposure to triggers, or ongoing reminders of the trauma

Biological risk factors:

• Having a genetic predisposition toward anxiety
• Being a member of a racial or ethnic minority group
• Having parents or siblings with a history of mental illness
• Being assigned female at birth 
• Being of a young age at time of traumatic experience/stressor (younger age is linked to higher likelihood of developing symptoms)
• Having a heightened startle response

Psychological risk factors:

• Decreased ability to regulate one’s emotions
• Existence of other mental illnesses, particularly depressive disorder, obsessive-compulsive disorder (OCD), or panic disorder
• Fatalistic attitudes
• A tendency to use self-blame or avoidance as a coping strategy
• Dissociation during the traumatic or stressful experience
• Neuroticism

The goal of treatment for other specified trauma- and stressor-related disorders is typically to facilitate the emotional processing of the traumatic event or life stressor, which typically results in the reduction of symptoms. 

Medication

The U.S. Food and Drug Administration (FDA) has not approved any medications specifically to treat any of the subtypes of other specified trauma- and stressor-related disorder. However, a number of medications are used to treat symptoms of other conditions in the same category, such as PTSD.

It is important to note that medication alone is usually not considered to be an effective treatment of any disorder involving trauma or stress, including other specified trauma- and stressor-related disorders, and therapy is usually recommended.

Medications that are used for post traumatic stress disorder (PTSD) include:

• Selective serotonin reuptake inhibitors (SSRIs). Currently, only sertraline and paroxetine are approved by the Food and Drug Administration (FDA) for PTSD.

Many medications are prescribed “off label” for trauma- and stressor-related disorders, and these should only be used under the guidance of a licensed prescribing healthcare professional. It is important to consult with a doctor or medical professional before beginning or changing any medication plan. The information provided in this article is not intended as medical advice; please consult a qualified healthcare professional for personalized guidance. 

Self-care

For a number of reasons, self-care can be difficult for people with other specified trauma- and stressor-related disorder. It is common to have negative beliefs about oneself as a result of traumatic experiences, so patients may not believe they are deserving of care. Some of the basics of self-care, such as sleep, can be disrupted by trauma-related symptoms like nightmares. People who have experienced trauma or are undergoing stressful experiences may also turn to unhealthy coping mechanisms, such as substance use, which can negatively impact overall health and well-being.

Although it may be complicated for people with other specified trauma- and stressor-related disorder to practice self-care, self-care can be an effective way of counteracting the negative effects of trauma and stress. Eating a balanced diet, exercising often, and sleeping eight hours every night can enhance physical wellness, calm an overtaxed nervous system, and alleviate symptoms.

The anxiety and nervousness that can accompany other trauma- and stressor-related disorder may make it seem difficult to attend a traditional therapy appointment. In this situation, online therapy may be a helpful alternative. Through an online therapy provider such as BetterHelp, patients can attend meetings with their therapist from the comfort and convenience of their home.

While it can be difficult to find resources for other specified trauma- and stressor-related disorder in particular, many resources exist to support survivors of trauma and to help people process experiences of stress. The U.S. Department of Veterans Affairs’ National Center for PTSD provides information on the impacts of trauma and stress that are not exclusive to those with a PTSD diagnosis. The National Institute of Mental Health supplies a series of articles and links related to traumatic/stressful experiences, including self-care strategies, care provider databases, and information on what to expect when meeting with a therapist.

Please see our Get Help Now page for more immediate resources.

Much of the research involving trauma- and stressor-related disorders focuses on treatment options. One study examined the effectiveness of an internet-based CBT treatment for a subtype of other specified trauma- and stressor-related disorder, persistent complex bereavement disorder (PCBT). The researchers found that an online self-guided CBT program significantly reduced not only symptoms of PCBD, but also symptoms of depression and PTSD, which indicates that internet-delivered treatment may be a meaningful way to address trauma- and stressor-related disorders moving forward.

Another area of research involving trauma- and stressor-related disorders focuses on treatment options. One review from 2023 looked at the efficacy of online therapy and found that it reduced symptoms of not only stress, worry, post-traumatic stress disorder PTSD, and complex PTSD, but also depression and anxiety.

Here are some key statistics on traumatic events other specified trauma- and stressor-related disorder:

• Approximately 70% of adults are estimated to experience at least one traumatic event in their lifetime, with ~31% of adults estimated to experience four or more traumatic events, which can significantly increasing the likelihood of developing other specified trauma- and stressor-related disorder. 
• One study published in the Journal of Traumatic Stress found that women were more likely than men to be diagnosed with severe stress and adjustment disorder.
• In the same study, people who had a diagnosis of a stress disorder had a depression incidence rate of 77%. 
• One subtype of other specified trauma- and stressor-related disorder, persistent complex bereavement disorder, has a prevalence of around 7% to 10% in adults.