Background
The temporality of the emergence of symptoms following exposure to a potentially traumatic event is variable.
Objectives
The purpose of our research is to investigate the etiopathogenic hypotheses concerning the question of the latency phase which sometimes precedes the emergence of post-traumatic stress disorders.
Materials and methods
We conducted a review of the psychiatric literature concerning delayed-onset post-traumatic stress disorders. Hypotheses from the psychoanalytic literature were then discussed, as well as neuroscientific hypotheses.
Results
This diagnosis has two possible definitions: a considerable delay in the emergence of symptoms, or the presence of early symptoms that are not very specific and not attributed to the effects of the event on the psyche. The etiological hypotheses found in the literature involve the role of denial, emotional detachment, and early avoidance. The role of the occurrence of a later triggering event, the intensity of the event with psychotraumatic potential, the protective role of social support systems, and the hypotheses related to cognitive aging were also highlighted. Furthermore, numerous studies have shown that the subjective experience of a perceived threat was a more reliable predictor of the likelihood of developing post-traumatic stress disorders than a supposedly objective assessment of danger. From a neuroscientific perspective, a study published by Smid and al. in 2022 found that since different traumatic experiences share common elements, each new event with psychotraumatic potential would activate the same memory structure, which would reinforce the interconnections of this memory network. This could explain the role of a later triggering event in the development of delayed post-traumatic disorders. On a psychoanalytical level, according to the Freudian concept of après-coup, the first event is initially without consequence, but it is transformed by a second event, and it becomes retroactively traumatic. We discussed two hypotheses: either the first event left an unsymbolized trace, it was not integrated into the signifying chain, and it was subsequently integrated later on due to the second event, either the first event was symbolized at the moment of its occurrence, and in the light of a second subsequent event, it assumed a new meaning. The establishment of several psychic defense mechanisms could also explain the delayed onset of symptoms. From an interdisciplinary perspective, the study of the concept of trace, developed by researchers such as F. Ansermet and P. Magistretti, has enabled us to shed light on our subject. The experience transcribed in the form of traces could undergo changes due to plasticity, the trace being thus able to associate with other traces on the occasion of exposure to other events.
Conclusions
Th
背景暴露于潜在创伤性事件后出现症状的时间是可变的。目的探讨创伤后应激障碍出现之前的潜伏期问题的致病假说。材料与方法我们对有关迟发性创伤后应激障碍的精神病学文献进行了综述。然后讨论了精神分析文献中的假设，以及神经科学的假设。结果这种诊断有两种可能的定义：症状出现的相当延迟，或者早期症状的存在不是很具体，也不是归因于事件对心理的影响。在文献中发现的病因假说包括否认，情感脱离和早期回避的作用。随后的触发事件的发生、具有心理创伤潜力的事件强度、社会支持系统的保护作用以及与认知老化有关的假设也得到了强调。此外，许多研究表明，感知威胁的主观体验比所谓的客观危险评估更可靠地预测了患创伤后应激障碍的可能性。从神经科学的角度来看，Smid等人在2022年发表的一项研究发现，由于不同的创伤经历具有共同的元素，每一个具有心理创伤潜力的新事件都会激活相同的记忆结构，这将加强这一记忆网络的相互联系。这可以解释在迟发性创伤后障碍的发展中，较晚的触发事件所起的作用。在精神分析层面上，根据弗洛伊德的apr -coup概念，第一个事件最初是没有后果的，但它被第二个事件改变了，它变成了追溯性的创伤。我们讨论了两种假设：要么第一个事件留下了非符号化的痕迹，它没有被整合到能指链中，后来由于第二个事件而被整合，要么第一个事件在发生的那一刻被符号化了，然后在第二个后续事件的光照下，它被赋予了新的意义。一些心理防御机制的建立也可以解释症状的延迟发作。从跨学科的角度来看，由F. Ansermet和P. Magistretti等研究人员开发的对痕迹概念的研究使我们能够阐明我们的主题。由于可塑性，以痕迹形式转录的经验可能会发生变化，因此，在暴露于其他事件的场合，痕迹能够与其他痕迹联系在一起。结论创伤后应激障碍症状的延迟出现问题突出了精神生活的移动性和不确定性，以及预测创伤后应激障碍的困难。
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