What Are The PTSD Risk Factors?

Scientists do not know what exactly causes PTSD to develop. Re-experiencing a traumatic event in your past could be your brain’s way of processing the experience. 

Having a singular traumatic experience can trigger PTSD. However, it can also occur due to several traumatic events or ongoing traumatic experiences. 

Ongoing traumatic events, especially throughout a person's childhood, such as neglect or abuse, can also cause someone to develop another condition known as complex PTSD (C-PTSD). 

Feeling fearful during or after a traumatic event is not unusual. The fear response in the brain can trigger changes within your body to help you defend yourself against danger. This is called the ‘fight or flight response.

Most people will experience a range of emotions and reactions following traumatic experiences. However, most people who undergo trauma recover from these reactions naturally. Individuals who continue experiencing these symptoms and reactions after an initial period may have developed PTSD. 

Signs and symptoms of PTSD

Most people who have undergone a traumatic experience will experience symptoms that may occur over a short-term period. 

Most of these people will not develop PTSD that is ongoing or chronic. PTSD can also develop in people who have not gone through dangerous or personally life-threatening events, such as the death of a loved one.

In general, symptoms of PTSD begin within three months of the traumatic event occurring, but they can also begin years later. To be diagnosed with PTSD, symptoms must last over one month and affect everyday life, such as in work or relationships.

Recovery from PTSD varies greatly between people. Some people can recover within six to 12 months of treatment. However, some individuals can experience symptoms for a much longer amount of time. The condition can be chronic, often referred to as complex PTSD.¹

For an individual to be diagnosed with PTSD, a person must experience symptoms from set criteria for at least one month. These include:

• Two or more mood and cognition-based symptoms

• Two or more reactivity and arousal symptoms

• One or more avoidance symptoms

• One or more symptoms of re-experiencing

Mood and cognition symptoms

Symptoms may include:

• Loss of interest in activities

• Feeling guilt or blame

• Forgetting key events about the traumatic experience

• Negative thoughts and self-talk

Following a traumatic event, mood and cognition symptoms can show up or become worse. These feelings and symptoms can make an individual feel detached or alienated from their loved ones.

PTSD can often accompany other disorders, such as anxiety, depression, and substance abuse.

These symptoms can often occur for weeks or months after a traumatic event. If symptoms last for more than one month, seriously affect a person’s daily life, are not a result of substance abuse, or cause other medical issues apart from the traumatic experience, this may be PTSD.

Some people with PTSD do not show symptoms for long after the event. 

Reactivity and arousal symptoms

Symptoms may include:

• Experiencing outbursts of anger

• Insomnia or difficulty sleeping

• Feeling ‘on edge’

• Being easily frightened

These symptoms often occur constantly and chronically instead of being triggered by events that remind an individual of the traumatic event. People who experience these symptoms can become angry or stressed easily and find it difficult to partake in their normal daily routines, such as eating and sleeping.

Avoidance symptoms

Symptoms could include:

• Avoiding areas, objects, or events that can remind an individual of a traumatic event

• Avoidance of feelings and thoughts about the traumatic experience

Symptoms such as these that remind a person of a traumatic experience can trigger avoidance tendencies. These symptoms can cause an individual to change their daily routine. For example, someone who has had a car accident may avoid traveling in a car. 

Re-experiencing symptoms

Symptoms may include:

• Scary or frightening thoughts

• Insomnia and nightmares

• Mental flashbacks

Some people can feel as though they are reliving the traumatic event several times. When this occurs, an individual may experience physical symptoms such as sweating or a racing heart. 

Symptoms can begin through the thoughts and feelings of someone who has experienced a traumatic event. Events, objects, phrases, and situations can set somebody off and trigger re-experiencing symptoms. 

Risk factors for developing PTSD

People can develop PTSD at any stage in their life. Often, it occurs in people who have undergone serious physical or sexual assaults, abuse, accidents, natural disasters, or war. Women are more likely to be diagnosed with PTSD than men.

Several factors influence the development of PTSD, which include:

Genetic factors

Many studies have researched the role of genetic factors in the development of PTSD. One study² found that a high risk of developing PTSD can be passed down through generations. There are several genes related to this.

They found that genetic heritability's influence on PTSD was between 5 and 20% and varied depending on sex.

Social and socioeconomic factors

• A lack of social support for people who have undergone traumatic events is a critical risk factor for those at risk of developing PTSD. The need for support and resources following a traumatic event is essential in helping people process their emotions and trauma in a safe, healthy way.

• Socioeconomic factors such as an individual’s income, access to food, healthcare, housing, and education can influence the risk of developing PTSD.

  • Asylum seekers and refugees face a higher risk of developing PTSD due to their exposure to threats to their well-being. They can often have decreased access to basic necessities such as shelter and food and may face separation from their families.

  • Racial discrimination can increase the risk of PTSD due to the physical and emotional effects on victims.

Biological factors

Large cohorts of studies explore genetic and biological factors and their roles in the development of PTSD. PTSD can involve the dysfunction of several structures within the brain and can include a decreased brain volume. This is also found in disorders such as depression. 

Other factors

• Another risk factor for PTSD development is previous traumatic experiences. Trauma has a cumulative effect, which means that a person who may not have shown symptoms of PTSD can develop PTSD following subsequent traumatic experiences.

• Mental health conditions prior to trauma can also increase the risk of developing PTSD, especially in mental health conditions such as anxiety-related disorders and mood disorders.

Why do some people develop PTSD and other people do not?

Experts are still researching the reason that PTSD affects people differently. The reason that some people develop PTSD and others don't is still not fully understood. 

Several risk factors increase the chance of an individual developing PTSD. Often, people who do not have a strong support system are more likely to develop PTSD. People with few strong relationships with friends and family are more susceptible to physical and emotional responses to trauma. 

People who have other mental health issues, such as depression and acute stress disorder, have an increased risk of developing PTSD. Individuals with substance abuse problems are at a higher risk of developing PTSD. 

Treatments and therapies for PTSD

The main treatment options for individuals diagnosed with PTSD are psychotherapy and medications. PTSD affects everyone differently, and not all treatments will work for everybody. Mental health professionals experienced in diagnosing and managing people with PTSD can prescribe multiple treatments to find the correct treatment for a person’s symptoms. 

Often, people with PTSD go through ongoing trauma, such as sexual abuse or other abusive relationships. In these situations, both issues need to be addressed and resolved. Other ongoing problems that go hand in hand with PTSD are depression, anxiety disorder, panic disorder, suicidal thoughts, and substance abuse.

Medications

The most common medications for PTSD treatment are antidepressants. Antidepressants help to control symptoms of PTSD, such as anger, sadness, and anxiety. Other medications also help manage other symptoms, such as insomnia and nightmares.

It is important for a person with PTSD to talk to their healthcare professional about the treatment options available to them. To find the best medication for them, doctors will consult with them.

Therapy

Psychotherapy, also known as ‘talk therapy,’ involves discussing your experiences and feelings. It is often done in individual and group settings and can go on for six to 12 weeks.

Trauma-focused cognitive behavioral therapies can help people with PTSD. It involves opening up your trauma-associated feelings and replacing the irrational and scary thoughts with a different picture of what happened.

Eye movement desensitization and reprocessing (EMDR) therapy involves elements taken from cognitive behavioral therapy and eye movements or other simulations, for example, sounds or hand taps. This therapy changes how the brain processes information, which is overridden in stressful situations and traumatic experiences.

Family therapy can also be helpful to people who struggle with PTSD. Involving your family can help you work through problems with your loved ones and help them understand what you are going through.

Beyond treatment: how can I help myself?

Challenge yourself

The road to recovering from PTSD is a long one. Healing from trauma generally doesn't happen quickly and is never really complete. Trauma can make your life difficult, but there are many ways to cope with symptoms and decrease your feelings of fear, anxiety, and helplessness.

Trauma can leave you feeling fearful and helpless. It is important to overcome your feelings of powerlessness and remind yourself of your tenacity and ability to cope in difficult situations.

Helping others can help you regain your sense of self. Taking action in this way combats the symptoms of PTSD; reach out to your friends who may need your help, give blood, or donate your time to an important cause.

Exercise

Exercise releases endorphins, which can improve your mood. It can also help ground you and aid your nervous system to unstick itself from a stress response. 

Walking, swimming, running, or dancing can help you refocus your energy and thoughts on how your body is feeling. Other activities such as weight training, boxing, rock climbing, or martial arts can also help to focus your brain on your body movements.

Live a healthy lifestyle

PTSD can take a toll on your body, so taking time to relax and develop healthy lifestyle habits is important.

Having a healthy sleep schedule can help to regulate your nervous system. Sleep deprivation can make you moody, irritable, and angry and can exasperate PTSD symptoms. It is important to get 7–9 hours of sleep every night.

It is also helpful to ensure that your bedroom is a calm and relaxing space where you can have a restful night's sleep.

Eating a balanced diet can help to manage symptoms of PTSD. Ensure that you eat a healthy diet that includes fruit and vegetables to get the vitamins your brain needs to work properly.

Omega 3s can help regulate your emotional health, so it can be helpful to incorporate foods such as walnuts and fatty fish into your diet. Limiting processed, fried, and sugary foods can help control mood swings and stabilize energy levels.

When recovering from PTSD, it is important to limit or avoid drugs and alcohol. Individuals with PTSD can sometimes be drawn to alcohol to self-medicate with these substances to deal with their emotions and distressing memories. Using alcohol and drugs can worsen PTSD symptoms, interfere with medications and treatments, and strain relationships.

The lowdown

Several risk factors go into the development of PTSD. Emotional and psychological abuse, military service, sexual trauma, and your mental health history are just some of the factors that may increase your risk of developing PTSD. Genetics and gender, as well as your social and socioeconomic setting, also play a role in your risk.

There are several ways that PTSD symptoms present, such as flashbacks, nightmares, increased reactivity, and irritability. If you or someone you know is experiencing symptoms of PTSD, you should reach out for help, as you can be provided with resources to help you manage those symptoms. PTSD can cause strain on your self-worth and relationships with others.

People who are open to help have the best chance of regaining control over their lives and being able to process their trauma. 

FAQs

Do children react differently than adults with PTSD?

Children are susceptible to PTSD if they have experienced or witnessed abuse. In 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)³ acknowledged that PTSD could be diagnosed in people under six years old.

It is difficult to identify PTSD in children as they are typically unaware of the symptoms. Diagnosing PTSD is difficult and requires a lot of talking and thinking about what has happened in the past. Children sometimes do not have the tools to be able to express their experiences, which makes it difficult to identify the symptoms of PTSD.

Symptoms of childhood PTSD can look like this:

• Nightmares and difficulty sleeping (insomnia)

• Irritability

• Social withdrawal

• Anxiety

• Difficulty paying attention and concentrating

• Avoiding places and people associated with the traumatic event

• Persistent worry

• Attachment issues

PTSD is easier to treat in children than in adults. One study⁴ found that children with PTSD underwent successful treatment following a couple of hours of cognitive behavioral writing therapy and eye movement desensitization and reprocessing therapy (EMDR).

PTSD is easier to diagnose and more difficult to treat during adulthood. PTSD symptoms often show up by re-experiencing traumatic events through flashbacks or painful memories. Often, people with PTSD are hyper-aware of their surroundings and may always feel on edge.

Unlike children's brains, adult brains are much more inflexible, which means that PTSD is harder to overcome. Often, PTSD cannot be cured, but it can be treated and made manageable.

People who recognize PTSD symptoms in children and adults should consider reaching out and talking to a healthcare professional about undertaking treatment for their symptoms.

How is PTSD defined in DSM-5?

The full criteria are listed by the American Psychiatric Association.⁵ Fulfilling all of the criteria is required to be diagnosed with PTSD.

Criteria A (one or more required): The individual was exposed to threatened serious injury, or actual injury, death, or threatened death, or threatened, or actual sexual violence, in the following manner(s):

• Witnessing trauma

• Direct exposure to a traumatic event

• Indirect exposure to traumatic details, generally in professional duty (i.e., paramedics, first responders)

• Learning that a close friend or family member was exposed to trauma

Criteria B (one or more required): Re-experience of the traumatic event occurs persistently in the following manner(s):

• Nightmares

• Flashbacks

• Upsetting intrusive memories

• Emotional distress following exposure to a reminder of a traumatic experience

• Physical reactivity following exposure to a reminder of a traumatic experience

Criteria C (one or more required): Avoidance of trauma-related experiences following trauma in the following manner(s):

• Trauma-related reminders

• Trauma-related feelings and/or thoughts

Criteria D (two or more required): Worsened negative thoughts and/or feelings after trauma in the following manner(s):

• Difficulty in experiencing positivity

• Feelings of social isolation

• Intrusive or negative thoughts about the world or oneself

• Exaggerated blame of others or self for causing the trauma

• Negative affect

• Disinterest in activities one once enjoyed

Criteria E (two or more required): Trauma-related reactivity and arousal which began or became worse following trauma in the following manner(s):

• Aggression or irritability toward others

• Hypervigilance

• Difficulty sleeping or insomnia

• Difficulty concentrating on tasks

• Risky or destructive behavior

• Increased startle reaction

Criteria F (required): Symptoms last longer than one month.

Criteria G (required): Symptoms cause functional impairment or distress in the individual.

Criteria H (required): Symptoms are not brought on by illness, substance use, or medication. 

Specifications:

• The delayed specification is where the diagnostic criteria aren’t met until six months or more following the trauma, although the onset of symptoms may begin immediately

• The dissociative specification is where the individual may experience being an outside observer or feel detached from themself (i.e., the sufferer may feel as though they were in a dream or if something is not happening directly to them)

There is also a preschool-age subset (for children six years and under) of PTSD defined by DSM-5.

Which traumatic events are most likely to be associated with PTSD?

PTSD symptoms can result from traumatic experiences, including childhood abuse or neglect, military combat, racism, accidents, natural disasters, tragedies, or violence.

• Military veterans — Often, veterans return from military service with PTSD symptoms. It can be difficult for veterans to readjust to life out of service. Individuals may constantly feel emotionally numb or on edge and disconnected from reality. There are many ways to cope with PTSD symptoms, as well as depression, anxiety, and guilt, to regain control over your life.

• Sexual trauma — People who undergo sexual trauma and assaults can develop PTSD. This can make people feel ashamed, scared, and alone and trigger nightmares and flashbacks. It is important to seek help to regain your sense of self, security, and trust.

• Racial trauma — People who experience racial discrimination, abuse, or injustice can experience PTSD. This can lead to feelings of decreased self-worth, substance abuse, anxiety and depression, thoughts, hypervigilance, and flashbacks or nightmares.

• Psychological and emotional trauma — Experiencing stressful and traumatic events, or series of events, can leave you feeling helpless or as if you have no control over your emotions.

• Events such as experiencing the death of a loved one, accident, injury, bullying, humiliation, or domestic abuse can be distressing and can leave you with psychological and emotional trauma. Even if the trauma occurred recently or a long time ago, people can recover from PTSD symptoms, feel safe again, and move on with their lives.