Trauma in the Eye of the Beholder: Objective and Subjective Definitions of Trauma

The primary purpose of this article was to examine the correspondence of subjective and objective experiences of traumatic events. In Study 1 a clinical cutoff score for the Centrality of Events Scale (CES), which was used to operationalize subjective experience, was determined. In Study 2, a surprisingly large lack of overlap between subjectively and objectively defined experiences was found. Only 37% of objectively traumatic events were experienced as subjectively traumatic; in contrast, 73% of subjectively traumatic events met the objectively traumatic criterion. Both types of events were independently associated with higher levels of PTSD symptoms, depression, perceived stress, and quality of life in comparison to nontraumatic events. Events that were both objectively and subjectively traumatic were associated with the highest levels of PTSD symptoms. The observation that posttraumatic distress is expressed differentially on the basis of subjective experience offers interpretive clarity and carries important clinical implications of the CES.