Exposure to a traumatic event doesn’t guarantee the development of post-traumatic stress disorder (PTSD). However, certain factors can increase the likelihood. These can be categorized into three main phases: pre-trauma, peri-trauma, and post-trauma (Breslau et al., 2000).

Pre-Trauma Factors:

• Prior trauma exposure: Experiencing earlier traumatic events, particularly in childhood, raises the risk for subsequent PTSD (Nader et al., 2000). This may be due to sensitization of stress pathways or impaired coping mechanisms.
• Mental health history: Pre-existing anxiety, depression, or other mental health issues can heighten vulnerability to PTSD (Kessler et al., 2005). This could be due to shared risk factors like neurotransmitter imbalances or coping styles.
• Personality traits: Neuroticism, characterized by negative emotions and low stress tolerance, may increase PTSD risk (Koenen et al., 2005). Conversely, traits like extraversion and resilience may act as protective factors.
• Family history of mental illness: Having a family member with PTSD or other mental illnesses may indicate a genetic predisposition to stress-related disorders, increasing vulnerability (Yehuda et al., 2009).

Peri-Trauma Factors:

• Nature of the trauma: Events marked by intense fear, horror, or helplessness, like sexual assault or combat, carry a higher risk of PTSD (Nutt & Bryant, 2004). Perceived threat and lack of control are key factors.
• Severity and duration of trauma: More severe or prolonged trauma exposure, such as witnessing multiple casualties in war, is associated with increased PTSD risk (Breslau et al., 2000). The amount of stress exceeds coping capacity.
• Social support: Lack of social support after a trauma can worsen symptoms and hinder recovery, while strong social networks might act as buffers against PTSD (Pietrzak et al., 2011). Sharing the experience and feeling supported can promote healing.

Post-Trauma Factors:

• Coping strategies: Avoidance coping, like withdrawing from reminders of the trauma, can actually maintain PTSD symptoms (Ehlers & Clark, 2000). Effective coping strategies, such as seeking support and engaging in healthy activities, can lessen the risk.
• Stressful life events: Additional stressors after the trauma, such as financial problems or relationship issues, can exacerbate PTSD symptoms and hinder recovery (Monroe & Simons, 1999). Cumulative stress overloads coping mechanisms.
• Substance abuse: Self-medication with alcohol or drugs to manage difficult emotions can worsen PTSD symptoms and impede treatment progress (Kessler et al., 2005). Substance abuse can create additional problems and complicate trauma recovery.

What Qualifies as Traumatic?

Traumatic events involve exposure to actual or threatened death, serious injury, or sexual violence (American Psychiatric Association, 2013). They evoke intense fear, helplessness, and horror, exceeding normal human coping capacity. While the DSM-5 defines specific types of trauma, individual experiences vary considerably.

Do All People Experience Trauma in the Same Way?

No, individuals differ in their perception and response to trauma (Breslau et al., 2000). Cultural context, personal history, and resilience influence how someone interprets and copes with a traumatic event. Some may develop PTSD, while others might experience different reactions like depression, anxiety, or acute stress disorder.

Can PTSD Only Be Experienced by Combat Veterans?

Absolutely not! While PTSD is often associated with combat veterans, it can affect anyone exposed to qualifying traumatic events (National Institute of Mental Health, 2020). This includes survivors of natural disasters, accidents, sexual assault, domestic violence, and other forms of violence.