RISK FACTORS AND RESILIENCE

The likelihood of developing PTSD is affected by several individual and societal risk factors and an individual’s resilience.

Risk Factors

Risk factors that make individuals more likely to develop PTSD after a traumatic event are listed below. Intentional trauma has a greater association with PTSD than unintentional/nonassaultive trauma.

• Female gender
• Racial trauma
• Childhood adversity, including trauma/abuse
• Less education
• Sexual abuse or assault
• Extreme life events (e.g., car accidents, fires, medical emergencies)
• Active-duty combat
• Lower socioeconomic status
• Family instability, lack of a social support system
• Previous trauma prior to index traumatic event
• Physical injury (including traumatic brain injury) as part of the traumatic event
• Experiencing intense or long-lasting trauma
• Initial severity of reaction to the trauma
• Drug, alcohol, and other substance misuse
• General childhood adversity
• Personal and family psychiatric problems, including anxiety or depression
• Occupation choice (e.g., firefighter, emergency medical services [EMS], military, police)
• Sleep disorders such as insomnia or sleep apnea
  (Sareen, 2023; PTSD Alliance, 2023)

Resilience

Many people are affected by traumatic events, but a majority of them recover from stress reactions and do not go on to develop PTSD. The ability to recover quickly from or adjust easily to traumatic events involves a degree of resilience.

Resilience is the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands. A few factors contribute to how well people adapt, including:

• The ways in which individuals view and engage with the world
• The availability and quality of social resources
• Specific coping strategies

A coping strategy is an action or series of actions or thought processes used to meet a stressful or unpleasant situation and to modify one’s reaction to it. Coping strategies typically involve a conscious and direct approach to problems, in contrast to the use of defense mechanisms, which are patterns of reactions employed by the ego to protect itself from anxiety.

Resilience involves behaviors, thoughts, and actions that can be learned and developed. Increasing resilience takes time and intention, focusing on four major components: connection, wellness, healthy thinking, and meaning. These include:

• Building connections with others
• Fostering wellness of body and mind
• Finding purpose and meaning
• Learning healthy ways of thinking (e.g., keeping things in perspective)
• Seeking professional help when needed
  (APA, 2023a)