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Glossary of terms — Preamble and acknowledgements

A shared understanding of the common terms used to describe psychological trauma, version 3.0

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This glossary of terms includes common terms used to describe mental health conditions arising from exposure to potentially psychologically traumatic events and other stressors. The glossary is a collaboration between multiple partners, including organizations working in mental health, academia, research, and government.

Why is this important?

The glossary of terms 3.0 aims to promote a shared understanding of the common terms used to describe mental health challenges arising from exposure to potentially psychologically traumatic events. The glossary is intended to represent the next vital step towards the development of a universally shared understanding of several common terms, because how we use language matters.

Beyond the importance of standardized language, the glossary has broader implications for:

  • Reducing stigma
  • Increasing access to evidence-based care
  • Supporting ongoing improvements in the tools, training and treatments intended to benefit all Canadians.

Using common language can also discourage the use of dehumanizing or stigmatizing terms, encourage reflection to assess our own assumptions and the impacts of our language choices, and reinforce the use of safer, more inclusive and culturally competent language.

As well, having a common language can enable the mental health and well-being needs of those Canadians who step up to work in front-line and high-risk professions to be better addressed, for the benefit of us all.

Summary of methods and results

Development of version 3.0 of the glossary was led by a team of senior authors, assisted by a pan-Canadian team of contributors including academics, clinicians, community stakeholders and people with lived experience of psychological trauma. A systematic approach was used to:

  • Inform the development of the glossary to acknowledge the ever-evolving language of posttraumatic stress disorder (PTSD) and related terminology
  • Acknowledge the substantial impacts of the pandemic and the substantial toll the pandemic has taken on the mental and physical health of members in essential professions
  • Provide shared language accessible to all individuals that bridges the gaps between public safety personnel, active military members, Veterans, Family members, health care professionals, and the diverse communities they serve.

The terms for Glossary 3.0 were determined through an intensive review process, which included discussions with experts in the field and people with lived experience. Four rounds of review suggested new terms to be included in Glossary 3.0 and identified current terms requiring updated definitions.

Background

In 2018, the Government of Canada passed Act C-211, a piece of legislation that addresses the increased risk of PTSD and the need for access to care for those in front-line professions who serve the Canadian public, including first responders and other public safety personnel (PSP), Canadian Armed Forces (CAF) members and Veterans. In 2019, a glossary of terms (i.e. the Glossary) was developed to mobilize PTSD knowledge following the Act’s call for the creation of a Federal Framework on PTSD.

The Glossary recognizes the need for accessible definitions of relevant terminology to increase our common understanding of the nature of PTSD.

The first version of the Glossary was developed to 1) facilitate open discourse among attendees of the 2019 federal government National Conference on PTSD, 2) assist in the development of the Federal Framework on PTSD, and 3) address the key priorities outlined in Supporting Canada’s public safety personnel: An action plan on post-traumatic stress injuries. A revised version of the Glossary was released the same year, based on feedback on the first version. Version 2.1, with minor editorial revisions, was posted on the website of the Canadian Institute for Public Safety Research and Treatment (CIPSRT) in 2020.

Development of version 3.0 of the Glossary began in 2021. Given the COVID-19 pandemic’s far-reaching effects on the lives of all Canadian front-line workers, the focus of Glossary 3.0 has been expanded to include health care professionals, as well as serving PSP, CAF members and Veterans.

Discussions around PTSD and related mental health conditions often lack a common language for people living and working in different contexts. The Glossary is intended to bridge those gaps by promoting a shared understanding of the common terms used to describe mental health challenges arising from exposure to potentially psychologically traumatic events.

Glossary 3.0 marks the first version to be published in a peer-reviewed journal: Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice (the HPCDP Journal).

New terms in version 3.0

  • Anxiety Disorder
  • Caregiver Burden
  • Caregiver Satisfaction
  • Clinical Anxiety
  • Clinical Depression
  • Cultural Competency / Cultural Competence
  • Equity, Diversity, and Inclusion (EDI)
  • Evidence-Based Activities
  • Evidence-Based Medicine
  • Gender-Based Violence
  • Informal Caregiver
  • Institutional Betrayal / Sanctuary Trauma
  • Intersectionality
  • LGBT Purge
  • Military Sexual Trauma
  • Moral Injury* / Moral Distress / Moral Dilemmas
  • Panic Attack
  • Peer Support
  • Posttraumatic Psychological Stress / Posttraumatic Stress / Posttraumatic Stress Syndrome / Posttraumatic Stress Symptoms / Psychological Stress / Psychological Trauma* / Psychologically Traumatic Stress* / Traumatic Stress
  • Potentially Psychologically Traumatic Event (PPTE) / Psychologically Traumatic Event* / Potentially Psychologically Traumatic Stressor / Psychologically Traumatic Stressor (PTS)* / Traumatic Event / Traumatic Stressor
  • Provider
  • Sanctuary Trauma
  • Secondary Traumatic Stress
  • Social Support
  • Stigma
  • Vicarious Trauma
  • Wellness Check

*Refers to terms that appeared in previous iterations but have been updated to include new terms that reflect current terminology.

Acknowledgements

The Atlas Institute for Veterans and Families is pleased to be a member of a cross-organizational collaboration that came together to update the glossary of terms to version 3.0. The glossary would not have been possible without the contributions and the collaboration of the following individuals and organizations.

Contributors

We acknowledge the following organizations (in alphabetical order) who collaborated to make this resource a reality:

  • Atlas Institute for Veterans and Families
  • Canadian Institute for Military and Veteran Health Research (CIMVHR)
  • Canadian Institute for Pandemic Health Education and Response (CIPHER)
  • Canadian Institute for Public Safety Research and Treatment (CIPSRT)
  • Department of National Defence Terminology Board
  • McMaster University
  • Public Health Agency of Canada
  • Queen’s University
  • Veterans Affairs Canada
  • University of Toronto

We are grateful to the following individuals for their contributions to the development of this glossary (contributors are listed alphabetically by last name):

  • LCol (Ret’d) Suzanne Bailey, Curriculum Development Lead, Road to Mental Readiness, Canadian Forces Health Services Group, Department of National Defence
  • Mary Bartram, PhD, RSW, Director, Policy, Mental Health Commission of Canada, Adjunct Research Professor, School of Public Policy and Administration, Carleton University
  • Suzette Brémault-Phillips, OT, PhD, DCA, Associate Professor, Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta; Director, HiMARC (Heroes in Mind, Advocacy and Research Consortium), University of Alberta
  • Lori Buchart, PhD, DBA, co-founder and former co-chair, It’s Not Just 20K (INJ20K, formerly It’s Not Just 700)
  • Col Marilynn S. Chenette, CD, CHE, Deputy Commander, Health Services Division (HS Div), Canadian Armed Forces
  • Heidi Cramm, PhD, OT Reg. (Ont.), Professor, School of Rehabilitation Therapy, Queen’s University
  • Michelle Douglas, Executive Director, LGBT Purge Fund
  • Susan Dowler, PhD, CPsych, Chief Clinical Psychologist, Canadian Forces Health Services Group, Department of National Defence
  • A/Superintendent Lorraine Downey, BBA, Operations, Peer Support Coordinator, Ottawa Paramedic Service
  • Gabrielle Dupuis, MSc, Director, Research Partnerships, Atlas Institute for Veterans and Families
  • Maya Eichler, PhD, Associate Professor, Political and Canadian Studies, Women’s Studies, Mount Saint Vincent University; Canada Research Chair in Social Innovation and Community Engagement and leader of the Centre for Social Innovation and Community Engagement in Military Affairs, Mount Saint Vincent University
  • Murray Enns, MD, FRCPC, Professor, Department of Psychiatry, University of Manitoba; Medical Director and Staff Psychiatrist, Operational Stress Injury Clinic; Staff Psychiatrist, Adult, Health Sciences Centre; Adjunct Scientist, Manitoba Centre for Health Policy
  • Kyle Handley, Clinical Psychologist, York Regional Police, Chair of the Canadian Association Chiefs of Police Psychological Services Committee
  • Marnin J. Heisel, PhD, CPsych, Professor, Departments of Psychiatry and of Epidemiology & Biostatistics, University of Western Ontario; Scientist, Lawson Health Research Institute
  • Christine Hutchins, Senior Director, Office of Women and LGBTQ2 Veterans, Veterans Affairs Canada
  • Ruth Lanius, MD, PhD, FRCPC, Professor, Department of Psychiatry; Director of Posttraumatic Stress Disorder research unit; Harris-Woodman Chair in Psyche and Soma, Schulich School of Medicine & Dentistry, Western University; Collaborating Clinical Scientist, Homewood Research Institute
  • Vivien Lee, PhD, CPsych, Chief Psychologist, Commander, Healthy Workplace Team, Ontario Provincial Police; Clinical Advisor, Boots on the Ground
  • Brent MacIntyre, BA (Hons.) Criminology, BA Sociology, Respect, Ethics and Values, Ottawa Police Service
  • Randi McCabe, PhD, CPsych, Professor, Department of Psychiatry & Behavioural Neurosciences, McMaster University; Co-founder, Hamilton Centre for Cognitive Behavioural Therapy
  • Megan McElheran, PhD, RPsych, Clinical Psychologist, Wayfound Mental Health Group
  • Margaret McKinnon, PhD, CPsych, Homewood Chair in Mental Health and Trauma, Professor and Associate Chair, Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University; Research Lead, Mental Health & Addictions Services, St. Joseph’s Healthcare Hamilton; Senior Scientist, Homewood Research Institute
  • Anthony Nazarov, PhD, PMP, Associate Scientific Director, MacDonald Franklin OSI Research Centre; Research Scientist and Adjunct Research Professor, Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University; Adjunct Scientist, Lawson Health Research Institute; Adjunct Research Professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University
  • Andrew Nicholson, PhD, Assistant Professor, School of Psychology, University of Ottawa; Director of Clinical Research, Atlas Institute for Veterans and Families
  • Deborah Norris, PhD, Professor, Department of Family Studies & Gerontology, Mount Saint Vincent University
  • Scott Patey, OFS Peer Support Co-Coordinator, Ottawa Fire Services
  • Alain Pellegroms, Training Coordinator, OFS Medical Program Coordinator, OFS Peer Support Coordinator, Training Division, Ottawa Fire Service
  • Jill Price, PhD, Postdoctoral Fellow, Canadian Institute for Public Safety Research and Treatment (CIPSRT); Sessional Professor, Campion College, University of Regina
  • Rosemary Ricciardelli, PhD, Professor and Research Chair in Safety, Security, and Wellness, School of Maritimes Studies, Fisheries and Marine Institute, Memorial University of Newfoundland
  • J Don Richardson, MD, FRCPC, Consultant Psychiatrist, Medical Director, St. Joseph’s Health Care London’s Operational Stress Injury Clinic; Scientific Director, MacDonald Franklin OSI Research Centre; Medical Advisor, Atlas Institute for Veterans and Families; Professor and Wellness Lead, Tanna Schulich Chair in Neuroscience and Mental Health, Schulich School of Medicine & Dentistry, Western University; Associate Scientist, Lawson Health Research Institute
  • Maya Roth, PhD, CPsych, Clinical Psychologist, St. Joseph’s Healthcare London’s Operational Stress Injury Clinic; Affiliated Scientist, MacDonald Franklin OSI Research Centre; Associate Member, Yeates School of Graduate Studies, Toronto Metropolitan University; Adjunct Clinical Professor, Schulich School of Medicine and Dentistry, Western University; Associate Scientist, Lawson Health Research Institute
  • Martine Roy, Chair, Board of Directors, LGBT Purge Fund
  • Capt (Ret’d) M.E. Sam Samplonius, Co-founder, INJ20K
  • PC Benny Seto, BBE, Mobile Crisis Intervention Team, Toronto Police Service
  • Norman Shields, PhD, CPsych, National Chief Psychologist, Occupational Health and Safety Branch, Royal Canadian Mounted Police
  • Lorraine Smith-MacDonald, PhD, MA, MDiv, CCC, Postdoctoral Fellow, Heroes in Mind, Advocacy, and Research Consortium (HiMARC), Faculty of Rehabilitation Medicine, University of Alberta
  • Heather Stuart, PhD, FRSC, CM, Professor, Department of Public Health Sciences, Department of Psychiatry and the School of Rehabilitation Therapy, Queen’s University; Bell Canada Chair Mental Health and Anti-Stigma Research, Queen’s University
  • LCol Dr. Andrea Tuka, CD, MD, FRCPC, Clinical Assistant Professor, Department of Psychiatry, University of British Columbia; Chief of Psychiatry, Canadian Armed Forces

The senior authors team includes the following (listed alphabetically by last name):

  • Elizabeth Bose, MSc, Knowledge Translation Coordinator, Canadian Institute for Pandemic Health Education and Response (CIPHER)
  • Nicholas Carleton, PhD, RD Psych, Scientific Director, Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina; Professor of psychology, Department of Psychology, University of Regina
  • Dianne Groll, PhD, Adjunct Associate Professor, Departments of Psychiatry and Psychology, Queen’s University
  • LCol (Ret’d) Dr. Alexandra Heber, FRCPC, Chief of Psychiatry, Veterans Affairs Canada; Executive Director, Canadian Institute for Pandemic Health Education and Response (CIPHER); Associate Professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University
  • Yasaman Jabbari, PhD, Research Coordinator, Trauma and Recovery Research Unit, Department of Psychiatry and Behavioural Neurosciences, McMaster University; PhD Student, Cognitive Psychology, Department of Psychology, Neuroscience, and Behaviour, McMaster University
  • Jillian Lopes, MSc, Clinical Psychology, Department of Psychology, Neuroscience, and Behaviour, McMaster University; Research Assistant, Trauma and Recovery Research Unit, Department of Psychiatry and Behavioural Neurosciences, McMaster University
  • Ashlee Mulligan, MSc, Director, Partnerships and Stakeholder Engagement, Atlas Institute for Veterans and Families, The Royal
  • Kimberly Ritchie, PhD, MN, BScN, Assistant Professor, Trent/Fleming School of Nursing, Trent University; Adjunct Professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University
  • Amber Schick, MA, Research Associate, Canadian Institute for Pandemic Health Education and Response (CIPHER)
  • Emily Sullo, MMASc, BSc (Hons), Research Assistant, Trauma and Recovery Unit, Department of Psychiatry and Behavioural Neurosciences, McMaster University; PhD Student, Clinical Psychology, Department of Psychology, Neuroscience, and Behaviour, McMaster University
  • Linna Tam-Seto, PhD, OTReg (Ont.), Assistant Professor, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto
  • Valerie Testa, MSc, BEd, BA (Hons), OCT, CCRP, Senior Policy Analyst, Trauma Supports and Wellbeing Unit, Prevention Division, Centre for Mental Health and Wellbeing, Public Health Agency of Canada

In addition, we would like to thank our contributors’ employers and universities for allowing their members the time needed to contribute to this glossary.

The senior authors team also wishes to acknowledge all the people with lived experience and other stakeholders who dedicated their time and provided thoughtful contributions in collaboratively defining military sexual trauma.