Risk and protective factors

In addition to understanding some of the social and cultural differences in how trauma can be experienced and expressed, it’s also helpful to understand personal risk and protective factors. Risk factors increase vulnerability to experiencing trauma after a traumatic event. Protective factors decrease the likelihood that a person will experience severe and enduring trauma reactions.

Here is a diagram illustrating some of the factors that can contribute to the development of severe and enduring trauma reactions (like PTSD) and other psychiatric disorders after experiencing traumatic events.

The next two sections discuss risk and protective factors in more detail.

Risk factors
Research has identified several factors that influence the likelihood of experiencing trauma following a potentially traumatic event. Some of these are situational (e.g., the nature and type of event) and some are personal (e.g., history of psychiatric illness). These risk factors are:

• The nature and intensity of the traumatic event: The type of traumatic event may play the single biggest role in predicting trauma-related difficulties. For example, research suggests that experiencing or witnessing a personal and intentional act of human cruelty (such as rape or an armed attack) generally results in a higher risk of experiencing enduring trauma reactions than experiencing or witnessing an impersonal and/or accidental traumatic event (like destruction caused by a hurricane).
• The length of exposure to stressful and traumatic situations: As exposure lengthens, risk increases.
• The number of other stressors being experienced at the same time: Those who are experiencing multiple significant life-events (such as the death of a parent or relocating internationally) at the time the traumatic event occurs tend to be more vulnerable to experiencing trauma reactions.
• The nature and intensity of traumatic events experienced in the past: There is no escaping our own personal histories when it comes to traumatic events. While our greatest personal wounds can lead to a desire to help others in need, confronting their distress and trauma can trigger our own memories of hurt and betrayal. This is important to keep in mind, since recent research suggests that at least one third of humanitarian workers have undergone personal traumatic events prior to any experiences they may encounter in the field.
• History of previous psychiatric illness: Those with a prior history of psychiatric illness, especially those who have experienced acute stress disorder or post-traumatic stress disorder, tend to be more vulnerable to experiencing trauma again.
• Lack of social support: People we know well, who are kind and trustworthy, play an important role in protecting us from the effects of stress and trauma. Recent research suggests that those with low levels of social support are 4 times more likely to experience traumatization and 2.5 times more likely to experience some form of physical illness. This may be why individuals without partners are also at greater risk.
• Temperament and personality: Habitually negative and/or anxiety-prone individuals are more vulnerable to reacting more frequently and intensely to stressful events, and may be more prone to being traumatized.

Protective factors
In contrast, the following factors tend to help people thrive in the face of adversity. They buffer individuals against the effects of stressful experiences and help them cope with the transitions resulting from significant life-events. They foster resilience and generally help people recover more quickly and completely following significant trauma:

• Social support: Well-developed interpersonal skills, extraversion, and the ability to secure and maintain a healthy nurturing social network are vital to emotional health and stability. Recent research suggests that strong interpersonal relationships may provide the best protection in highly stressful environments.
• Optimism and healthy self-esteem: An optimistic outlook, regular experiences of positive emotions, a healthy self-esteem, and faith in self are traits that foster hardiness and resilience.
• Spirituality: Spirituality incorporates a person's vision of a moral order, search for meaning and purpose, hope for the future, and in some cases religious beliefs. In general, spirituality is an effective protective factor. The exceptions appear to be when someone’s spirituality is naïve (untested and/or not thoughtfully constructed) or when people are particularly rigid in their spiritual beliefs. In these instances, individuals who are faced with a traumatic event can be more vulnerable to the shattering of rigid worldviews, loss of sense of meaning and purpose, negative self-images, and other psychological difficulties.
• Adaptability: A certain degree of flexibility in belief structure, emotional experience, and worldview is a protective factor.
• Tendency to seek meaning: A natural tendency to find meaning and purpose in events, especially stressful events that challenge an individual, is a protective factor.
• Ability to mentalize: Mentalizing “involves being aware of mental states in oneself and others – feelings, needs, desires, beliefs, attitudes and so forth. When we mentalize we make sense of our own actions and of the actions of others. We are able to have distance from our emotional mind and bring more rational, clearer ideas about our earlier experiences to the fore” (Lewis, Kelly & Allen, 2004, p. 16).
• Curiosity and openness to experience. Curiosity and openness to new experiences are related to adaptability, hardiness, and resilience.
• Aptitude: Resourcefulness, intellectual mastery, and general capability are protective factors.

Next: Examining your current well-being