Trauma and psychiatry

Over the last decade, psychological trauma has re-emerged as a critical factor in psychiatric discourse. The ubiquity of traumatic stress, extending from the hidden ‘epidemic’ of violence within families to the vexed challenges posed by the chaotic geopolitical challenges since 9/11, has forced psychiatry to engage again with the area. This chapter examines the ethical challenges arising from the reformulation of posttraumatic stress disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, trauma-informed care in health systems, recent progress in the understanding of the psychobiology of traumatic stress, and how psychiatrists must position themselves in an increasingly illiberal society that often fails to protect the most vulnerable people.