Continuous Traumatic Stress: Expanding the Lexicon of Traumatic Stress

Despite substantial theoretical and empirical advances in the field of traumatic stress since the introduction of the diagnosis of posttraumatic stress disorder (PTSD) into the mental health nomenclature, existing conceptualizations of traumatic stress retain the assumption that traumatic experiences have occurred in the past. We propose continuous traumatic stress (CTS) as a supplementary construct within the lexicon of traumatic stress, to describe the experience and impact of living in contexts of realistic current and ongoing danger, such as protracted political or civil conflict or pervasive community violence. We discuss four key characteristics of CTS and consider these in relation to existing formulations of complicated traumatic stress: the context of the stressor conditions, the temporal location of the stressor conditions, the complexity of discriminating between real and perceived or imagined threat, and the absence of external protective systems. We advance a tentative descriptive picture of how CTS may present and discuss the potential adaptive and pathological dimensions of the phenomenon.