[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Letters to the Editor
December 2007

Trauma in Childhood

Author Affiliations

Copyright 2007 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2007

Arch Gen Psychiatry. 2007;64(12):1451. doi:10.1001/archpsyc.64.12.1451-a

Copeland et al1 found that more than two-thirds of children in western North Carolina are victims of trauma before their 16th birthday. Yet less than 0.5% developed posttraumatic stress disorder (PTSD).

The striking discrepancy between the prevalence of trauma and the prevalence of PTSD is partly explained by conceptual bracket creep in the definition of trauma. The broader the concept of trauma, the lower the rate of PTSD is likely to be. Indeed, no longer need one be directly exposed to a potentially fatal event to qualify as a victim of trauma. People who merely learn about the serious misfortunes of others now qualify as trauma survivors themselves. As Copeland et al observed, such indirect experiences account for many cases of exposure in their study.