History of Trauma - Prior trauma, especially where PTSD developed, makes individuals especially succeptable to repeated bouts of PTSD. This is likely due to the ease with which unresolved past traumas are recalled and reexperienced, as well as the likelihood of reenacting past faulty coping behaviors (Schiraldi, 2000). Life Stressors - Recent events in a person's life that are not of traumatic magnitude (e.g., job loss, divorce, financial problems) can weaken the person's defenses against trauma-induced stress in the same way that hardship can weaken the immune system (Schiraldi, 2000). Poor Coping Skills - Deficits such as low self-esteem, emotionality, and resilience can increase a person's chance of developing PTSD. The advantage of this set of vulnerability factors is that they are all learnable. In fact, suffering through PTSD can actually promote improvement of these deficits Schiraldi, 2000). Personality - Certain long-standing traits, such as pessimism and introversion, deny a person the tools needed to deal with a challenging affliction such such as PTSD. These, too, are modifiable, but not to the same degree as coping skills (Schiraldi, 2000). Genetics - It appears that vulnerability to PTSD can be passed on through generations, and worsened by certain behaviors such as drug abuse and trauma experience (Schiraldi, 2000).
A traumatic event is more likely to adversely affect the victim if, in the initial period following the event, he or she (1) dissociates, (2) believes that they are responsible in some way or did not do all they could to remedy the situation as it occurred, and (3) feels alone or isolated. Each of these conditions creates artificial separation from or unnecessary shame in regards to the event (Schiraldi, 2000). Severity of Trauma - With low-level stress or trauma, personal vulnerabilities weigh more heavily in determining the development of PTSD (Durand, 2006). Also, more severe traumas tend to lead to PTSD more often and result in more chronic cases. Proximity to Trauma - A person's proximity to a trauma has been found to be directly related to their degree of resulting distress and PTSD development. An interesting demonstration of this phenomenon was found in the 1987 study of children at an Los Angeles elementary school who survived a sniper shooting at their playground. The closer the children were to the playground (where the bullets were fired, some were killed, and many were injured), the higher their reported stress reaction scores and incidence and severity of PTSD (Pynoos et al., 1987). Type of Trauma - Trauma type (e.g., sexual assault, natural disaster) interacts with various other factors (e.g., age, gender, trauma severity) to reveal differing susceptibilities to PTSD per type. See the bottom of this page for specific probabilities of PTSD associated with certain traumas. Nature of Trauma - A victim's vulnerability to PTSD increases if the trauma is sudden, unpredicted, enduring, or recurring. Also, the risk of developing PTSD rises if the event poses a real threat of harm to the victim, if the trauma is multidimensional (potential harm in multiple ways, e.g., natural disaster followed by drought), and if the trauma occurs early in life (here, the trauma has a more profound effect on a developing personality)
Lack of social support - The most crucial protective factor from PTSD after a trauma is the ability to rely on family, friends, and community to prevent isolation and distract the victim from the traumatic memories. Often others are unavailable because they too experienced the trauma or perhaps because of their lack of connection with their own emotions. Seemingly supportive individuals sometimes make the victim feel that they should "just get over it" (Briere, 2004). Blaming the Victim - For whatever reason, some victims of trauma (most notably rape victims) are shamed or disbelieved in regard to the occurrence of the event. This rejection serves only to compound the distress of the victim. Another prime example of this was the reception of Vietnam veterans after the war. On top of the "shell shock" they were struggling with, the soldiers had to deal with a public disapproving of the war for which they sacrificed (Schiraldi, 2000). Secondary Victimization - This occurs when those who are supposed to help victims in the posttraumatic period actually worsen the stress by subtly blaming the victim. An example is when police officers might ask a rape victim if she thinks the crime could have been prevented had she worn less revealing clothes (Schiraldi, 2000). Lack of Treatment - Whether intentional or ignorant, not seeking treatment further isolates the victim and allows PTSD to progress chronically. The most effective, empirically-based treatment is currently Cognitive Behavioral therapy, specifically exposure therapy. Progressively and safely reexposing the victim to aspects of the trauma can associate new, positive memories with the event (Schiraldi, 2000). Current research estimates that only 38% of PTSD sufferers are undergoing treatment during a given year. The most popular reason for not seeking treatment was that they did not think they had a problem. This treatment rate, however, is comparable to or higher than the same rates of treatment for depression and anxiety related disorders