Sheila Rauch, PhD: Who Is More Likely to Develop PTSD After Trauma?

Most people who experience a trauma will not develop PTSD. But whether from a natural disaster, car crash, combat exposure, or sexual assault, those who develop PTSD tend to avoid dealing with the trauma’s “stuck memories” or feel unable to handle negative emotions and experiences.

Sheila Rauch, PhD is the deputy director of the Emory Healthcare Veterans Program.

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Most people who experience trauma will not develop PTSD. Most people recover and are resilient. It’s a significant percentage though who will have this memory get stuck. And we think there are a couple of things that feed into being more likely for that memory to get stuck. One is people who have a traumatic experience and then they try to push it out of their head and avoid it and not think about it and pretend it didn’t happen and not be around anything that reminds them. Those people are more likely to have PTSD symptoms over time. They’re kind of not able to think about what happened to them, to find meaning about it, to explain it, to kind of move through it and move to the other side because they’re too busy pushing it away. And then the other piece that really puts people at a higher risk of post-traumatic stress disorder symptoms over time is some specific thoughts that “I’m not able to handle negative affect”, that “I am damaged by this traumatic experience, I’m forever damaged and there’s nothing I can do about it”. That sense of personal incompetence and inability to handle negative affect tends to be a strong predictor of who’s going to have PTSD symptoms over time. So, there’s a wide range, and really it can be any kind of situation where someone feels like their life or their personal integrity is in danger. And it can range from a natural disaster, like a tornado or a hurricane, all the way to combat exposure or sexual assault or motor vehicle accidents. Probably the most frequent trauma that humans experience in the United States are motor vehicle accidents. But the rates of PTSD following motor vehicle accidents are pretty low. So, as far as PTSD, you can get it from a motor vehicle accident. You’re probably less likely. You’re much more likely to end up with PTSD over the long haul when the traumatic experience involves some kind of interpersonal interaction or violence towards the self or other, whether that’s sexual assault, physical assault, or combat exposures. Physical pain, oftentimes, as I mentioned previously, it can be a reexperiencing symptom. So, it can be a trigger where when someone feels pain, it reminds them of the injury that they had at the time of the trauma, they start thinking of the trauma, and so on. But in addition to that, oftentimes when we are in emotional pain, many of us will express that emotional pain in physical symptoms. And one physical symptom that some people experience is that chronic pain, that as you’re in a negative mood, or experiencing more PTSD symptoms, they’re more likely to report experiencing more severe pain, less ability to manage that severe pain, and less coping resources basically. BrainLine is powered in part by Wounded Warrior Project to honor and empower post-9/11 injured service members, veterans, and their families.

Posted on BrainLine September 23, 2021. Reviewed September 23, 2021.

About the author: Sheila A.M. Rauch, PhD, ABPP

Sheila A.M. Rauch, PhD, ABPP, is the Deputy Director of the Emory Healthcare Veterans Program and Director of Mental Health Research and Program Evaluation at the VA Atlanta Healthcare System. Dr. Rauch has been developing programs, conducting research and providing PTSD and Anxiety Disorders treatment for over 20 years. Her research focuses on examination of mechanisms involved in the development and treatment of PTSD and improving access to effective interventions.

Professional headshot of Dr. Sheila Rauch smiling at the camera, wearing glasses in a royal blue top