Peritraumatic Reactions and Posttraumatic Psychopathology

Although not every trauma-exposed individual develops a mental health problem, a considerable proportion experience conditions such as posttraumatic stress disorder, depression, and anxiety disorders. This review aims to examine the relationship between peritraumatic reactions, defined as acute psychological and physiological responses that occur during or immediately after a traumatic event, and posttraumatic stress symptoms as well as related mental health problems. Within this scope, core peritraumatic responses including peritraumatic distress, peritraumatic dissociation, tonic immobility, mental defeat, and peritraumatic somatoform dissociation are discussed. Findings indicate that these reactions are critical determinants of long-term psychological outcomes and can influence the processing of traumatic experiences through their effects on memory encoding, threat appraisal, and emotion regulation mechanisms. In particular, high levels of peritraumatic distress and dissociation may contribute to the persistence of traumatic memories in a fragmented, decontextualized, and intrusive form. Tonic immobility and mental defeat, on the other hand, may intensify symptom severity by reinforcing secondary cognitive and emotional processes such as perceived loss of control, helplessness, shame, and self-blame. At the neurobiological level, alterations in networks involved in emotion regulation and contextual memory, particularly those associated with the amygdala, hippocampus, and prefrontal cortex, are emphasized as potential mechanisms increasing vulnerability to posttraumatic psychopathology. Early assessment of peritraumatic reactions and the development of response-sensitive intervention strategies are therefore crucial for the prevention of trauma-related psychological disorders.