Trauma trigger

The trigger can be anything that provokes fear or distressing memories in the affected person, and which the affected person associates with a previous traumatic experience. Just as trauma is not merely an unpleasant or adverse experience, a trauma trigger is not merely something that makes a person feel uncomfortable or offended.{{Cite book |last=Greenberg |first=Tamara McClintock |url=https://books.google.com/books?id=pzn1DwAAQBAJ&dq=ptsd+trigger+uncomfortable&pg=PA5 |title=Treating Complex Trauma: Combined Theories and Methods |year=2020 |publisher=Springer Nature |isbn=978-3-030-45285-8 |pages=5 |language=en}} Some common triggers are:

• a particular smell – such as freshly mown grass, the fragrance of an aftershave product or perfume. The sense of smell, olfaction, may be more closely connected to traumatic reminders than other sensory experiences.{{cite journal |last1=Vermetten |first1=Eric |last2=Bremner |first2=J. Douglas |title=Olfaction as a Traumatic Reminder in Posttraumatic Stress Disorder: Case Reports and Review |journal=The Journal of Clinical Psychiatry |date=15 February 2003 |volume=64 |issue=2 |pages=202–207 |doi=10.4088/jcp.v64n0214 |pmid=12633130 }}
• a particular taste – such as the food eaten during or shortly before a traumatic experience
• a particular sound – such as a helicopter or a song
• a particular texture
• certain times of day{{cite book |last1=Foa |first1=Edna B. |last2=Keane |first2=Terence M. |last3=Friedman |first3=Matthew J. |last4=Cohen |first4=Judith A. |title=Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies |date=2008 |publisher=Guilford Press |isbn=978-1-60623-792-2 |page=107 |url=https://books.google.com/books?id=MFyEg007YEIC&pg=PA107 }} – for example, sunset or sunrise
• certain times of year or specific dates – for example, autumn weather that resembles the affected person's experience of the weather during the September 11 attacks,{{cite book |last1=Cori |first1=Jasmin Lee |title=Healing from Trauma: A Survivor's Guide to Understanding Your Symptoms and Reclaiming Your Life |date=2007 |publisher=Hachette Books |isbn=978-1-60094-061-3 |page=30 |url=https://books.google.com/books?id=D3XB0b_l2q0C&pg=PA30 }} or the anniversary of a traumatic experience
• sights – (real, photo, film or video) for examples, a fallen tree or a light shining at a particular angle
• places – for example, a bathroom, or all bathrooms{{cite book |last1=Foa |first1=Edna B. |last2=Keane |first2=Terence M. |last3=Friedman |first3=Matthew J. |last4=Cohen |first4=Judith A. |title=Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies |date=2008 |publisher=Guilford Press |location=224 |isbn=978-1-60623-792-2 |url=https://books.google.com/books?id=MFyEg007YEIC&pg=PA224 }}
• a person, especially a person who was present during a traumatic event or resembles someone involved in that event in some respect
• an argument
• a sensation on the skin – such as the feeling of a wristwatch resembling the feeling of handcuffs, or sexual touching for victims of sexual assault
• the position of the body{{cite book |last1=Follette |first1=Victoria M. |last2=Briere |first2=John |last3=Rozelle |first3=Deborah |last4=Hopper |first4=James W. |last5=Rome |first5=David I. |title=Mindfulness-Oriented Interventions for Trauma: Integrating Contemplative Practices |date=2017 |publisher=Guilford Publications |isbn=978-1-4625-3384-8 |page=304 |url=https://books.google.com/books?id=y20sDwAAQBAJ&pg=PA304 }}
• physical pain
• emotions – such as feeling overwhelmed, vulnerable, or not in control
• a particular situation – for example, being in a crowded place

The trigger is usually personal and specific. However, it need not be closely related to the actual experience. For example, after the Gulf War, some Israelis experienced the sound of an accelerating motorbike as a trigger, which they associated with the sound of sirens they heard during the war, even though the resemblance between the two sounds is limited.{{cite book |last1=Lahad |first1=Mooli |last2=Doron |first2=Miki |title=Protocol for Treatment of Post Traumatic Stress Disorder: See FAR CBT Model : Beyond Cognitive Behavior Therapy |date=2010 |publisher=IOS Press |isbn=978-1-60750-574-7 |page=9 |url=https://books.google.com/books?id=4iFlPSVxmqcC&pg=PA9 }}

The realistic portrayal of graphic violence in visual media may expose some affected people to triggers while watching movies or television.{{cite news |last=Ephron |first=Dan |title=Battlefield flashbacks | work = Newsweek |date=1 October 2006 }}{{vs|date=August 2021}}

File:Firecrackers lit by hand.jpg

People who have experienced trauma and who have developed trauma triggers may panic when the trigger is experienced, especially if it is unexpected. For example, the noise of fireworks may seem unbearable to a combat veteran whose trauma is coupled with sudden, loud noises as the trigger.

{{Redirect|Trigger warning|other uses|Trigger Warning (disambiguation){{!}}Trigger Warning}}

{{Redirect|Content warning|the 2024 video game|Content Warning}}

Trigger warnings, sometimes called content warnings, are warnings that a work contains writing, images, or concepts that may be distressing to some people.{{cite news | work =Ouch blog |title= Trigger warnings: What do they do?|url= https://www.bbc.co.uk/news/blogs-ouch-26295437 |publisher=BBC|date= 25 February 2014|access-date=25 February 2014}} Content warnings have been widely used in mass media without any connection to trauma, such as the US TV Parental Guidelines, which indicate that a show includes content that some families may find inappropriate for their children.{{Cite book|author1-link=Keith Whittington|last=Whittington|first=Keith E.|url=https://books.google.com/books?id=S396DwAAQBAJ&dq=%22content+warnings%22+parents&pg=PA58|title=Speak Freely: Why Universities Must Defend Free Speech|year=2019|publisher=Princeton University Press|isbn=978-0-691-19152-2|pages=57–59|language=en}} The term trigger warning, with its trauma-specific context, originated at feminist websites that were discussing violence against women, and then spread to other areas, such as print media and university courses. Although it is widely recognized that any sight, sound, smell, taste, touch, feeling or sensation could be a trigger, trigger warnings are most commonly presented on a relatively narrow range of material, especially content about sexual abuse and mental illness (such as suicide, eating disorders, and self-injury).{{cite magazine|last=Jarvie|first=Jenny|date=3 March 2014|title=Trigger happy|magazine=The New Republic|publisher=Chris Hughes|url=https://newrepublic.com/article/116842/trigger-warnings-have-spread-blogs-college-classes-thats-bad}}

In the case of non-fiction books and online videos, only specific chapters or segments may have trigger warnings, providing timestamps and page numbers that allow the audience to easily skip only certain parts, rather than the entire work. This may be more difficult to employ in works of fiction, where skipping certain parts disrupts the narrative flow.

The idea of giving content warnings to university students about their coursework has been disputed and politicized. Much of the dispute centers around content warnings given to all students about the presence of generally uncomfortable subjects in the curriculum, such as racism and misogyny. There is no significant dispute over providing reasonable accommodations to the small number of students (usually current and former military personnel and sexual assault survivors) who qualify as having a disabling level of post-traumatic stress disorder and whose ability to learn the normal curriculum can be improved, for example, by mentioning in advance that the next reading assignment contains a detailed description of a violent event or that an upcoming ballistic pendulum demonstration will produce loud sounds.

In 2014, the American Association of University Professors criticized the use of general content warnings in university contexts, stating, "The presumption that students need to be protected rather than challenged in a classroom is at once infantilizing and anti-intellectual. It makes comfort a higher priority than intellectual engagement and...it singles out politically controversial topics like sex, race, class, capitalism, and colonialism for attention."{{cite web|url=https://www.aaup.org/report/trigger-warnings|title=On Trigger Warnings|date=August 2014|publisher=American Association of University Professors}} This view is supported by some professors such as Richard McNally, professor of psychology at Harvard, and some psychiatric medical practitioners, such as Metin Basoglu and Edna Foa.{{cite magazine|last1=McNally|first1=Richard|author-link=Richard McNally|date=20 May 2014|title=Hazards Ahead: The Problem with Trigger Warnings, According to the Research: Five studies you should read before you deploy a trigger warning.|url=https://psmag.com/education/hazards-ahead-problem-trigger-warnings-according-research-81946|magazine=Pacific Standard|access-date=7 August 2018}}{{cite news|last=Waters|first=Florence|date=4 October 2014|title=Trigger warnings: more harm than good?|work=The Telegraph|publisher=Telegraph Media Group|url=https://www.telegraph.co.uk/culture/books/11106670/Trigger-warnings-more-harm-than-good.html|access-date=4 February 2016}}{{cite news |last1=Waldman |first1=Katy |title=The Trapdoor of Trigger Words |url=http://www.slate.com/articles/double_x/cover_story/2016/09/what_science_can_tell_us_about_trigger_warnings.html |work=Slate |date=5 September 2016 }}Bridgland, Victoria ME, and Melanie KT Takarangi. "Something distressing this way comes: The effects of trigger warnings on avoidance behaviors in an analogue trauma task." Behavior Therapy 53, no. 3 (2022): 414–427.Bridgland, Victoria ME, Jorja F. Barnard, and Melanie KT Takarangi. "Unprepared: Thinking of a trigger warning does not prompt preparation for trauma-related content." Journal of Behavior Therapy and Experimental Psychiatry 75 (2022): 101708.Bridgland, Victoria, Payton J. Jones, and Benjamin W. Bellet. "A meta-analysis of the effects of trigger warnings, content warnings, and content notes." (2022). They believe that trigger warnings increase avoidance behaviors by those with PTSD which makes it harder to overcome the PTSD, create a culture that decreases resilience, and more geared towards political virtue signaling, and are "counterproductive to the educational process".{{cite news |last1=Marcotte |first1=Amanda |title=Why Are People So Triggered by Trigger Warnings? |url=https://slate.com/human-interest/2015/05/trigger-warnings-annoying-well-meaning-not-a-threat-to-free-speech.html |work=Slate Magazine |date=21 May 2015 }}

Since the publication of the American Association of University Professors' report, other professors, such as Angus Johnston, have supported trigger warnings as a part of "sound pedagogy".{{cite news |last1=Johnston |first1=Angus |title=A Professor Explains Why He's Pro-Trigger Warnings |url=https://slate.com/human-interest/2014/05/hostos-community-college-professor-angus-johnston-explains-why-trigger-warnings-have-a-place-on-campus-syllabuses.html |work=Slate Magazine |date=29 May 2014 }} Other supportive professors have stated that "the purpose of trigger warnings is not to cause students to avoid traumatic content, but to prepare them for it, and in extreme circumstances to provide alternate modes of learning."{{cite journal |last1=Lockhart |first1=Eleanor Amaranth |title=Why trigger warnings are beneficial, perhaps even necessary |journal=First Amendment Studies |date=2 July 2016 |volume=50 |issue=2 |pages=59–69 |doi=10.1080/21689725.2016.1232623 |s2cid=151901765 }}

Universities have taken different stances on the issue of trigger warnings. In a letter welcoming new undergraduates, the University of Chicago wrote that the college's "commitment to academic freedom means we do not support so-called 'trigger warnings'," do not cancel controversial speakers, and do not "condone the creation of intellectual 'safe spaces' where individuals can retreat from thoughts and ideas at odds with their own".{{cite news |last1=Schaper |first1=David |title=University Of Chicago Tells Freshmen It Does Not Support 'Trigger Warnings' |url=https://www.npr.org/2016/08/26/491531869/university-of-chicago-tells-freshmen-it-does-not-support-trigger-warnings |work=NPR |date=26 August 2016 }}{{Cite web |last=Ellison |first=John (Jay) |year=2020 |title='Dear Class of 2020 Students' Letter |url=https://news.uchicago.edu/sites/default/files/attachments/Dear_Class_of_2020_Students.pdf |website=University of Chicago News |publisher=University of Chicago}}{{Cite web |last=Grieve |first=Pete |title=University to Freshmen: Don’t Expect Safe Spaces or Trigger Warnings |url=https://chicagomaroon.com/22405/news/university-to-freshmen-dont-expect-safe-spaces-or-trigger-warnings/ |access-date=2023-10-22 |website=Chicago Maroon}} Students at UC Santa Barbara took the opposite position in 2014, passing a non-binding resolution in support of mandatory trigger warnings for classes that could contain potentially upsetting material. Professors were encouraged to make students aware of such material and allow them to skip classes that could make them feel uncomfortable.

Although the subject has generated political controversy, research suggests that trigger warnings are neither harmful nor especially helpful. Among people without traumatic experiences, "trigger warnings did not affect anxiety responses to potentially distressing material in general."{{cite journal |last1=Bellet |first1=Benjamin W. |last2=Jones |first2=Payton J. |last3=McNally |first3=Richard J. |date=December 2018 |title=Trigger warning: Empirical evidence ahead |journal=Journal of Behavior Therapy and Experimental Psychiatry |volume=61 |pages=134–141 |doi=10.1016/j.jbtep.2018.07.002 |pmid=30077703 |s2cid=51930369}} Furthermore, studies disagree on whether trigger warnings cause transient increases in anxiety in those without traumatic experiences.{{cite journal |last1=Bellet |first1=Benjamin W. |last2=Jones |first2=Payton J. |last3=Meyersburg |first3=Cynthia A. |last4=Brenneman |first4=Miranda M. |last5=Morehead |first5=Kaitlin E. |last6=McNally |first6=Richard J. |date=December 2020 |title=Trigger warnings and resilience in college students: A preregistered replication and extension. |journal=Journal of Experimental Psychology: Applied |volume=26 |issue=4 |pages=717–723 |doi=10.1037/xap0000270 |pmid=32281813 |s2cid=149505821}}{{cite journal |last1=Sanson |first1=Mevagh |last2=Strange |first2=Deryn |last3=Garry |first3=Maryanne |date=July 2019 |title=Trigger Warnings Are Trivially Helpful at Reducing Negative Affect, Intrusive Thoughts, and Avoidance |journal=Clinical Psychological Science |volume=7 |issue=4 |pages=778–793 |doi=10.1177/2167702619827018 |s2cid=150545454}} For participants who self-reported a posttraumatic stress disorder (PTSD) diagnosis, or for participants who qualified for probable PTSD, trigger warnings had little statistically significant effect.{{cite journal |last1=Jones |first1=Payton J. |last2=Bellet |first2=Benjamin W. |last3=McNally |first3=Richard J. |date=September 2020 |title=Helping or Harming? The Effect of Trigger Warnings on Individuals With Trauma Histories |journal=Clinical Psychological Science |volume=8 |issue=5 |pages=905–917 |doi=10.1177/2167702620921341 |doi-access=free}} Effect sizes on feelings of avoidance, decreased resilience, or other negative outcomes have been "trivial" in controlled research environments.

While trigger warnings have garnered significant debate, few studies have investigated how students typically respond to potentially triggering material. In a 2021 study, 355 undergraduate students from four universities read a passage describing incidents of both physical and sexual assault. Longitudinal measures of subjective distress, PTSD symptoms, and emotional reactivity were measured. Greater than 96% of participants read the triggering passage even when given a non-triggering alternative to read. Of those who read the triggering passage, those with triggering traumas did not report more distress although those with higher PTSD scores did. Two weeks later, those with trigger traumas and/or PTSD did not report an increase in trauma symptoms as a result of reading the triggering passage. Moreover, students with relevant traumas do not avoid triggering material and the effects appear to be brief. Also, students with PTSD do not report an exacerbation of symptoms two weeks later as a function of reading the passage.{{cite journal |last1=Kimble |first1=Matthew |last2=Flack |first2=William |last3=Koide |first3=Jennifer |last4=Bennion |first4=Kelly |last5=Brenneman |first5=Miranda |last6=Meyersburg |first6=Cynthia |title=Student reactions to traumatic material in literature: Implications for trigger warnings |journal=PLOS ONE |date=25 March 2021 |volume=16 |issue=3 |pages=e0247579 |doi=10.1371/journal.pone.0247579 |pmid=33765044 |pmc=7993791 |bibcode=2021PLoSO..1647579K |doi-access=free }}

Trauma triggers have been recognized by medical professionals since the 19th century.{{Cite journal|last1=Laguardia|first1=Francesca|last2=Michalsen|first2=Venezia|last3=Rider-Milkovich|first3=Holly|date=2017|title=Trigger Warnings: From Panic to Data|url=https://www.jstor.org/stable/26453524|journal=Journal of Legal Education|volume=66|issue=4|pages=882–903|jstor=26453524}}

==See also==

• Acute stress disorder – sometimes called being in shock
• Content rating – such as age-based labels for films
• Emotional dysregulation
• Hypervigilance – common symptom of PTSD
• Repressed memory
• Survivor guilt

{{Wiktionary|Appendix:Glossary of traumatology}}

{{Wikiquote}}

• {{cite web |title=Do Trigger Warnings Work? |url=https://www.nytimes.com/roomfordebate/2016/09/13/do-trigger-warnings-work |work=The New York Times }}
• {{cite news |title= Trigger warnings: What do they do?|url= https://www.bbc.co.uk/news/blogs-ouch-26295437 | work = Ouch |publisher=BBC News|date= 25 February 2014|access-date=25 February 2014}}
• {{cite news |last1=Lukianoff |first1=Greg |last2=Haidt |first2=Jonathan |title=How Trigger Warnings Are Hurting Mental Health on Campus |url=https://www.theatlantic.com/magazine/archive/2015/09/the-coddling-of-the-american-mind/399356/ |work=The Atlantic |date=11 August 2015 }}

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Category:Treatment of mental disorders