Christopher Michael
Argosy University, Honolulu Campus, Honolulu, HI 96816, USA.
Clin Psychol Rev. 2004 Mar;24(1):75-98. doi: 10.1016/j.cpr.2003.12.003.
The main goal of this paper is to articulate a biopsychosocial evolutionary approach to understanding the traumatic stress response. The secondary goal of this paper is to draw out the general clinical implications of this approach. I articulate seven interconnected and overlapping empirically grounded theoretical conclusions: (1) Stress is best understood as a prerational form of biopsychological feedback regarding the organism's relationship with its environment; (2) The normal outcome of traumatic stress is growth, rather than pathology; (3) Most psychopathology is a function of the maladaptive modulation of the stress response; (4) Trauma always leaves the individual transformed on a biological, as well as psychological, level; (5) The general biological process underlying stress responses is universal, but the specific dynamics are always a function of the unique sociocultural environment and psychological makeup of the individual; (6) The biology underlying stable psychopathological symptoms may change even as the psychological symptoms remain the same; and (7) Rationality is humanity's evolutionarily newest and most sophisticated stress-reduction behavioral mechanism, and the most important aspect of restoring psychological health to the trauma victim.
本文的主要目标是阐明一种生物心理社会进化方法，以理解创伤应激反应。本文的次要目标是引出这种方法的一般临床意义。我阐述了七个相互关联且重叠的基于实证的理论结论：（1）压力最好被理解为关于生物体与其环境关系的一种前理性生物心理反馈形式；（2）创伤应激的正常结果是成长，而非病理状态；（3）大多数精神病理学是应激反应适应不良调节的结果；（4）创伤总是使个体在生物学和心理层面上发生改变；（5）应激反应背后的一般生物学过程是普遍的，但具体动态总是个体独特的社会文化环境和心理构成的函数；（6）即使心理症状保持不变，稳定的精神病理症状背后的生物学机制也可能发生变化；（7）理性是人类进化中最新且最复杂的减压行为机制，也是使创伤受害者恢复心理健康的最重要方面。
