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What Is the Difference Between Big-T and Little-T Trauma?

When people think of trauma, they often picture war veterans or battered spouses; media depiction of trauma contributes to this impression. However, trauma comes from a wider range of sources than previously understood. For this reason, we can conceptualize trauma better by creating two categories: big-T trauma and little-t trauma.

Big-T Trauma

According to the Diagnostic and Statistical Manual of Mental Disorders: 5th Edition (DSM-5), trauma includes real or threatened death, serious injury, and/or sexual violence. Exposure to these events can also result in trauma. The event shocks the system, sending a person into fight, flight, fawn, or freeze mode. Most modern trauma specialists understand that this isn’t an entirely accurate definition of trauma. Instead, we classify these events as big-T trauma. One incident of big-T trauma impacts the amygdala and nervous system enough to cause long-lasting effects.

A systematic review published in PLoS One examined the prevalence of post-traumatic stress disorder (PTSD) in patients who experienced a single trauma as defined by the DSM-5 (hereafter called big-T trauma). By combining data from 58 unique studies, researchers found that 17% of individuals who experienced a big-T trauma fit the criteria for PTSD 12 months after the traumatic event. It’s worth noting that the intention of the traumatizer impacts that number: 11.8% of accidental big-T traumas resulted in PTSD, while 23.3% to 37.1% of intentional big-T traumas caused PTSD.

Little-T Trauma

Despite exclusion in the DSM-5, little-t traumas can cause serious impact. While little-t traumas are less obvious to outside viewers, they can cause serious psychological distress to the individual experiencing them.

Examples of little-t trauma include:

  • Bullying
  • Parental neglect
  • Medical problems
  • Housing instability
  • Exposure to the legal system

Do not be fooled by the name “little-t trauma.” It is no less significant than a big-T trauma. An isolated incident of little-t trauma may not cause a severe enough effect for long-term consequences. However, repeated or prolonged exposure to this type of trauma can severely impact individuals’ physical and mental health. The Kaiser-CDC Adverse Childhood Experience study displays the outcome of little-t traumas on youth populations as well as children. Little-t traumas create toxic stress that can result in many mental health conditions, including addiction.

Trauma is the precursor to many mental health issues. The DSM-5 definition limits our understanding to only major and severe events. Little-t traumas, however, can also have a significant impact. Whether big-T or little-t, trauma sets the groundwork for addiction, depression, anxiety, dissociative disorders, and PTSD. People may develop maladaptive behaviors to cope with the overwhelming stress. The Guest House provides comprehensive treatment for mental health disorders and addiction. Our staff specializes in treating the long-term effects of trauma. With our help, you can get yourself on a healthier path. Call us at (855) 483-7800.