Public awareness of post-traumatic stress disorder (PTSD) has increased dramatically over the past few decades, with most people understanding that PTSD can develop after a traumatic event. But when you consider that two people can experience the same event and walk away with very different outcomes, it becomes confusing.
What separates them is a combination of different risk factors. This could be due to the nature of the trauma experienced, or even pre-existing vulnerabilities that were already in place before the event happened.
This makes understanding these risk factors important in identifying when you, or someone you care about, may need support. This page will focus on:
In health and psychology, a risk factor is anything that increases the likelihood of developing a particular condition. It doesn’t guarantee that the condition will develop, but it does raise the chances.
For example, smoking is a well-known risk factor for lung cancer. Not every smoker will develop lung cancer, but the risk is significantly higher than for someone who has never smoked.
A risk factor for PTSD is anything that makes a person more likely to develop the condition after experiencing a traumatic event. These can include things that were already in place before the trauma, like personal history or biology, as well as the nature of the event itself. How well supported a person is in the aftermath also plays a huge part in whether or not PTSD develops.
This is where the common understanding of PTSD can fall short. The assumption that experiencing a traumatic event automatically leads to PTSD doesn’t reflect how the condition actually develops.
Research suggests that around 7% of the general population will experience PTSD at some point in their lives.[1] That means the majority of people who go through traumatic events will not develop the disorder. What separates those who do from those who don’t usually comes down to which risk factors were present before, during, and after the event.
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There are a number of trauma risk factors adults experience that can increase their chances of developing PTSD. These include:
Experiencing childhood trauma can be one of the biggest risk factors in developing PTSD, and this is largely due to the vulnerable emotional development stage. A child is still learning how to regulate their emotions, and if they’re subjected to highly stressful events, it can affect this stage deeply.2 These stressful events are known as Adverse Childhood Experiences, or ACEs, and if enough are experienced, the impact they can have on a child can carry well into adulthood.[2]
In the U.S., over two-thirds of young people report at least one traumatic experience by the age of 16.[3] Out of those numbers, it’s predicted that around 16% will go on to meet the criteria for PTSD later on in life.
Studies have found that girls appear to be more vulnerable than boys, with up to 15% going on to develop PTSD, compared with up to 6% in boys.[3]
For those who have been exposed to war in combat zones, the risk of developing PTSD dramatically increases. These types of environments repeatedly present life-threatening situations that place the person in a constant fight or flight state. There are also other negative psychological factors to deal with, like the loss of friends on the battlefield and dealing with injury.
Data shows that around 29% of Iraq and Afghanistan war veterans experience PTSD at some point after service.[4]
To put this into perspective, the rate for civilian lifetime PTSD sits at around 7%, showing that combat is a strong risk factor in the development of PTSD.[4]
First responders are repeatedly exposed to crisis situations as part of their daily work. The aftermath of violent scenes and medical emergencies is not a one-off event for these professionals. These situations are a routine part of the job, and this ongoing contact with traumatic situations puts a real strain on mental health.
The research suggests that around 20% of emergency paramedics had PTSD (in the past year of the study), which is far higher than the 3% rate seen in the general population.[5]
Other estimates suggest 30% of first responders develop a behavioral health condition compared with about 20% of people in non-emergency roles.[5]
The links between genetics and PTSD are complex, but studies have found that genetics can influence how likely a person is to develop the disorder.
Twin studies in particular estimate that around 30% of a person’s risk for PTSD comes from inherited factors.[6] It is thought that because genetics can influence how the body’s stress response system works, it can make some people more reactive in threatening situations.
But it’s crucial to remember that while genes may raise the baseline level of PTSD vulnerability, they don’t make it certain that the person will develop the condition.
For example, a person with low genetic risk can still experience trauma that develops into PTSD, and vice versa.
Chronic domestic violence is another strong predictor of PTSD development. Experiencing violence from someone you love is traumatic in itself, but the emotional pain can also have a huge impact. Emotional control, manipulation, and isolation often accompany the violence, and living under that kind of sustained threat from someone who is supposed to be safe can leave lasting psychological harm.[7]
Studies show that around 30–56% of adults who have experienced intimate partner violence meet the criteria for PTSD, making it a very strong predictor for development.[7]
Mental health conditions are another strong risk factor in the development of PTSD. Research suggests that having an existing mental health condition before experiencing trauma can raise the chance of later developing PTSD. One study found that people with any prior psychiatric diagnosis had roughly six-times higher risk of PTSD after stressful incidents.[8]
Below, we focus on three common mental health conditions, each of which is linked to higher PTSD risk in trauma survivors.
Studies show that pre-existing depressive disorders roughly triple the likelihood that a traumatic event will lead to PTSD.[9]
It is thought that someone already dealing with depression may have less emotional resilience and more negative thought patterns, which can make coping with new trauma harder.
People who already live with anxiety, whether that’s generalized anxiety or panic disorder, tend to perceive everyday situations as more threatening than they actually are. When a traumatic event occurs on top of that existing heightened state, the brain is already primed to respond with fear, which makes it more likely that PTSD symptoms will develop and take hold.[10]
This relationship works the other way around, too. Living with PTSD can intensify existing anxiety or bring on new mental health difficulties that weren’t there before, with around half of people with PTSD also experiencing major depression. Over 90% meet the criteria for at least one other psychiatric condition during their lifetime.[10]
What this could tell us is that anxiety and PTSD feed into each other, and if anxiety is already part of your life, it may raise the chance of developing PTSD after a trauma. Equally, if PTSD does develop, it can deepen the anxiety you were already carrying or create new challenges on top of it
Many personality disorders involve emotional instability or perfectionism, which can worsen trauma reactions. Research on accident survivors found that those who had personality disorders were far more likely to have chronic PTSD a year after they experienced the trauma.[11]
The study also noted that over half of the identified cases had obsessive-compulsive or other personality traits, but the key finding was that any diagnosed personality disorder raised the PTSD risk.[11]
Even without a formal diagnosis, personality factors like high neuroticism or strongly avoidant coping styles have been tied to greater PTSD vulnerability.
In the immediate moments after a traumatic event has happened, it’s normal to feel shaken or anxious. But if those feelings don’t ease after a few weeks, or they’re becoming so intrusive that they’re affecting day-to-day life, it’s a sign that extra help is needed.
You should also consider mental health support if you have experienced any of the traumatic events mentioned above, or have a history of PTSD in your family. Genetics and the type of event witnessed can be strong risk factors in the development of PTSD, so it’s worth getting a mental health screening if this applies to you.
For those who are apprehensive about seeking mental health treatment, know that early intervention doesn’t mean starting a full-blown program straight away; rather, it’s a chance to have a chat with a professional in the field. Their knowledge is important in the early detection of PTSD symptoms, and they may be able to spot aspects that might be difficult for you to notice yourself.
This is similar to the way we treat our physical health in that early intervention can stop an issue from becoming worse. Take a routine skin check-up after being sunburnt, as an example. If a mole is found that is concerning, the doctor will take the necessary steps to treat the source of the problem. This is similar to the early intervention for PTSD after a traumatic event, in that a mental health professional is able to spot the signs and make a decision on treatment going forward.
Ongoing distress is never something to be dismissed, and it’s risky to write it off as “something that will pass”. Undergoing a mental health screening is crucial because if PTSD is recognized, it gives healthcare professionals more options in preventing long-term issues.[9]
If distress becomes overwhelming or you’re experiencing thoughts of harming yourself or feeling unsafe, it’s important to seek immediate support through emergency services or a crisis helpline.
If you feel as though any of the subjects covered apply to you, it’s important to reach out for help. Even if you feel as though you’re coping in the aftermath of a traumatic event, it’s still worth seeking a professional second opinion.
Our team at A Mission For Michael works with people who are living with PTSD and other trauma-related mental health concerns. We understand that trauma affects everyone differently, which is why treatment with us is designed around you rather than following a rigid template.
Our clinicians use evidence-based therapies to help you process traumatic experiences and develop effective coping strategies. We use a range of therapies, including:
We also understand that the environment of treatment can play an important role in recovery, which is why we offer both outpatient and residential treatment options. These settings mean you’re able to continue daily responsibilities while attending treatment or have the chance to step away from everyday stressors to focus fully on your mental health.
Contact AMFM to learn more about our PTSD treatment programs and how we can support you on the path to recovery.
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At AMFM, we strive to provide the most up-to-date and accurate medical information based on current best practices, evolving information, and our team’s approach to care. Our aim is that our readers can make informed decisions about their healthcare.
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