Mental health experts have long understood that untreated psychological trauma can be a risk factor for anxiety, depression, posttraumatic stress disorder (PTSD) and other mental health concerns. Until recently, though, few researchers had publicly attempted to quantify the degree to which trauma can influence the likelihood that a person will struggle with a mental illness.
That changed in October 2022, when a research report revealed that people who have a history of trauma may be three times more likely to develop a mental health disorder than are members of the general public.
What Is Psychological Trauma?
Before we delve into the October 2022 paper, let’s take a moment to review what psychological trauma is and what types of experiences can cause it to occur.
Trauma is a distressing emotional response that occurs in the aftermath of a terrifying or otherwise deeply disturbing event or occurrence.
As described by the National Institute of Mental Health (NIMH), people who have lived through traumatic events often react in one or more of the following ways:
- They may become angry, sad, anxious, or fearful.
- They may find it difficult to focus or concentrate.
- They may struggle to get to sleep and stay asleep.
- They may be unable to stop thinking about the traumatic event.
When these types of responses occur for a short period of time after a traumatic event, they are neither abnormal nor evidence of a mental health disorder. But when they persist and intensify to the point that they compromise a person’s ability to function in one or more important areas of life, they become cause for concern.
For example, people who exhibit the following signs and symptoms after a traumatic experience may be in crisis:
- Changing their behaviors to avoid people, locations, or circumstances that remind them of the traumatic event
- Attempting to use alcohol or another drug to block their traumatic memories or numb their emotional distress
- Withdrawing from friends and family members
- Feeling that they are re-experiencing the traumatic event (a phenomenon that is often referred to as having a flashback)
- Acting with uncharacteristic aggression, violence, or recklessness
- Having dramatic, unpredictable mood swings
- Sensing that they are perpetually in danger, even when there is no credible threat
- Developing frequent headaches, stomach aches, muscle tension, and other physical symptoms as a result of their ongoing stress
Anyone who has been dealing with responses such as the ones listed above should be assessed by a qualified mental health professional. With proper care, a person can learn to manage the symptoms they have been experiencing and ease the impact that psychological trauma has had on their life.
Potential Sources of Psychological Trauma
When terms such as trauma and PTSD are mentioned, many people may first think of service members who have been involved in military combat. Warfare can absolutely be a source of trauma, but it is by no means the only experience that can lead to this outcome.
The many experiences that can inflict psychological trauma all share a common characteristic: They can cause a person to fear for their life, or for the life of someone they care about.
In addition to combat, other potential sources of psychological trauma include:
- Physical attacks
- Sexual assault
- Verbal or online harassment
- Acts of terrorism
- Kidnapping
- Automobile accidents
- Tornadoes, hurricanes, earthquakes, and other violent weather
- Serious illnesses
A person can develop psychological trauma after surviving one or more of the events listed above, witnessing a traumatic event that occurs to someone else, or learning the details of a loved one’s traumatic experience.
Some people develop psychological trauma after continued exposure to certain forms of trauma over an extended period of time (such as in cases of ongoing sexual abuse or child neglect). Also, individuals who are routinely exposed to the aftermath of traumatic events, such as emergency medical technicians (EMTs) and firefighters, may have an elevated risk for trauma.
Trauma & PTSD
Most people will experience or witness at least one traumatic event during the course of their lifetime. In fact, the National Center for PTSD reports that as many as 43% of people will be affected by trauma before they reach their 19th birthday.
However, the center also notes that only a relatively small number of people will develop posttraumatic stress disorder:
- In any given year, about 5% of the adult population in the United States will have symptoms of PTSD. In 2020, this meant that there were about 13 million cases of PTSD among U.S. adults.
- The lifetime rate of PTSD is slightly higher among women (8% of the adult female population) than among men (4% of adult males).
Of course, 13 million annual cases of PTSD is hardly a minor concern. But as these statistics indicate, the good news is that about 96% of men and 92% of women in the U.S. will never develop this devastating disorder.
As we will discuss in the following section, though, focusing solely on PTSD to assess the lasting impact of traumatic experiences ignores the many other mental health concerns that may have their origins in psychological trauma.
Trauma & Mental Illness
On October 8, 2022, the journal European Archives of Psychiatry and Clinical Neuroscience published a paper titled Psychological trauma as a transdiagnostic risk factor for mental disorder: an umbrella meta-analysis.
To conduct this meta-analysis, a team of researchers from Spain and Brazil assessed fourteen systematic reviews. These reviews covered 106 studies that involved 16,277 cases of people who had mental health disorders and 77,586 controls (study subjects who had not been diagnosed with a mental illness).
The goal of this effort was to gather evidence of a link between several forms of childhood trauma and the development of mental health disorders later in life.
The team described the strength of their findings with both a descriptor and an odds ratio:
- The four descriptors (listed in descending order from highest to lowest confidence) were convincing, highly suggestive, suggestive, and weak.
- An odds ratio of greater than 1 means that exposure to trauma has an increased likelihood of leading to a mental illness.
- An odds ratio of 2 indicates that a mental illness is twice as likely to occur after a certain type of trauma.
- Odd ratios of 3 or 4 equate to threefold or fourfold increases, respectively, in the likelihood that a mental illness will develop after a person is exposed to trauma.
In the abstract to their study, the team reported finding “highly suggestive evidence of an association between psychological trauma at any time-point and any mental disorder.” The team calculated an odds ratio (OR) of 2.92 for this link between trauma and mental illness. This means that people who are living with untreated trauma are nearly three times more likely to develop a mental health disorder than are people whose lives have never been impacted by trauma.
The research team also found the following associations between types of trauma and mental illnesses:
- Emotional abuse and anxiety disorders (evidence: convincing; odds ratio: 3.05)
- Physical abuse and a range of mental health disorders (evidence: convincing; odds ratio: 2.36)
- Childhood trauma and any mental disorder (evidence: highly suggestive; odds ratio: 2.90)
- Sexual abuse and various types of mental illness (evidence: highly suggestive; odds ratio: 3.47)
“Obviously, the etiology of why we are suffering from mental disorders is multifactorial with a genetic predisposition and further environmental variables,” one of the study’s authors, Benedikt Amann, said in a Jan. 10, 2023, article about the study, “but our work underlines that psychological trauma is one of the most robust and preventable risk factors for suffering a mental disorder later on.”
Gianna Melendez
Jodie Dahl, CpHT