Ask the Expert, Tamar Rodney, PhD, PMHNP-BC: Predispositions Can Cause Different Outcome from Trauma

Two people had a similar trauma from car crashes, but one is fine while the other still struggling a lot. Can you please explain? In this video, Dr. Rodney answers your questions about mental health treatment.

Tamar Rodney, PhD, PMHNP-BC, CNE is an assistant professor at Johns Hopkins School of Nursing. Her research and clinical work focus primarily on improving PTSD diagnosis and treatment.

For information about treatments for PTSD please visit The Treatment Hub.

Hi. I’m Tamar Rodney, a psych mental health nurse practitioner. And our question is: “Two friends of mine had a similar trauma from car crashes, but one is fine while the other’s still struggling a lot. Can you please explain?” And this is a wonderful question that we get so many times about what are the different experiences of trauma. So, I would first like to point out that actually car accidents and falls is the primary way individuals experience trauma. So, this is not a surprise.

What has been puzzling and where research has thrown itself is why is it that many individuals might be in the same environment, but they don’t respond equally? So, I want to break this up a little bit to say with full clarity is that we don’t actually know why. What is the unique mechanism is why individuals experience things different, and we don’t know, but what we do know is what puts individuals at greater risk to experience this.

So, emotional response to trauma is natural. It is a natural occurrence. We go through something difficult, and we’re going to respond in different ways. The continuum of what an individual might experience as difficult versus someone would say is not so difficult really has to do with our predisposition. And by this, I mean what other stressors we might have been going on before, what groups we fall into.

And by groups, I mean do you have other mental health problems? Did you previously suffer from anxiety or depression? Do you have other risk factors for you to develop post-traumatic stress disorder? Part of what the literature tells us is things like “women are more likely to experience PTSD more than men”, and that might simply be about their willingness to report symptoms. So, I sometimes struggle with this question because the other piece we look at is the timeline.

Not everybody’s going to experience this response to trauma at the same timeline, and so that’s going to vary. Some persons will show symptoms months after; sometimes it’s years. The important part is that regardless of how an individual responds to that trauma, recognizing that that situation was traumatic and providing the help we need whenever they need it. So, that’s uniquely important. So, for the friend who need that help right now, offer that help right now.

And it should be no surprise if six months down the line the other friend says I’m not doing so well. That is completely natural. And that is usually my approach when individuals go through the same experience but are experiencing it differently. I know it’s a difficult thing to explain, and I hope this provides some insight as to how we stratify risk and being patient with ourselves as we deal with what is undoubtedly a difficult event for anyone to go through.

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Posted on BrainLine November 17, 2021. Reviewed November 17, 2021.