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Trauma
By Katie Ott



Central Question: How does trauma effect college students differently than other age/social groups?


Abstract

Trauma is a subject that effects many people, but college students are at a particularly vulnerable stage in their life relative to other adults when it comes to dealing with trauma. This is due not only to their age relative to others, but their ability to cope with stress. College students have simply not lived long enough to develop strong coping mechanisms. Dealing with ordinary stressful situations is bad enough, but during their college careers approximately 66 percent of students experience a traumatic event. Of these cases, about nine percent will develop PTSD (Clemans). These statistics are disturbingly high, particularly when compared to the lower rates of trauma and PTSD development in other age groups.


Table of Contents

I. Types of Trauma
  • Physical
  • Emotional
  • Frequency and Groups Affected
II. How Trauma Effects the Brain
  • Differences in how People React to Trauma
  • Immediate Effects
  • Long-Term Effects
III. Post Traumatic Stress Disorder (PTSD)
  • What is it?
  • Who is Affected?
IV. Coping with Trauma: Treatment & Recovery
  • Immediate After-Effects of Traumatic Experiences
  • How do you know if you need help?
  • The Difference Between Problem and Emotion-Focused Coping Mechanisms
  • Moving on/Recovery
  • Benefits of Trauma
V. Conclusion/Response
VI. Motivation for Choosing this Topic
VII. References


I. Types of Trauma
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Physical
The most common forms of physical trauma include accidents and physical/sexual assaults. The highest injury rate of injuries in in the population of people around 20 years of age. College age students have the highest injury and mortality rate due to accidents than any other age group (D Fife, 1984).

Emotional
Trauma does not have to be physical. Witnessing a traumatic event such as the death or severe injury of a loved one can have as a mental effect on someone just as detrimental as if the experience had happened to them personally. Emotional abuse is also known to affect the psychological well-being of people, particularly children (Kira, 2012).

Frequency and Groups Affected
In a psychological study that looked at the frequency of different types of trauma, it was discovered that a mere third of the participants had never experienced any sort of traumatic event in their lives (Hirini, 2005)). Approximately 60 percent of men and 50 percent of women experience at least one traumatic event at some point during their lives (Clemans). Trauma is a very prevalent issue in society, one that can effect anyone regardless of background or lifestyle. Some people, however, are more at risk than others of not only experiencing trauma, but suffering stronger after effects. College students are at a significantly higher risk for experiencing trauma. The most common types of traumatic events experienced by college students are life threatening experiences and the death of a loved one. It is estimated that a third of college students will experience one or the other of these events (Clemans).


II. How Trauma Effects the Brain

Trauma can lead to a great deal of stress on an individual, and stress can cause damage in the CA3 region of the hippocampus (Cardena, 2005), an area of the brain largely responsible for learning and memory (Ciccarelli, 2013). In most cases damage to the hippocampus can only be seen in patients with chronic, severe PTSD, but the damage has to start somewhere, and it likely begins with the initial trauma and immediate accompanying stress (Cardena, 2005). Below is a video with more detail on different ways trauma can effect the brain.



Since trauma can have such significant effects on cognitive and social development, trauma in children and young adults is a more critical issue than trauma in people who's brains are fully developed. Children exposed to relational trauma in particular face a high risk of forming psychiatric disorders later in their lives (Kira, 2012).

Differences in how People React to Trauma
How people react to trauma depends very much on the person. Some people are genetically better equipped to handle traumatic experiences. Not everyone who suffered a traumatic event will need counseling to overcome it.



III. Post Traumatic Stress Disorder (PTSD)

What is it?
The Eastern Colorado Healthcare System Mental Illness Research, Education and Clinical Center defines PTSD as "an anxiety disorder resulting from exposure to an experience involving direct or indirect threat of serious harm or death; may be experienced alone (rape/assault) or in company of others (military combat)" (Clemans). People with PTSD often experience anxiety, avoidance symptoms, withdrawal, insomnia, irritability, and there is also some evidence that there may be a correlation between PTSD and heart disease (NIMH · Suspect Gene Variants Boost PTSD Risk after Mass Shooting).

Below is an image of a normal brain (left) and one of a patient with PTSD (right). The brain on the right has significantly fewer serotonin receptors, which are responsible for receiving mood signals (NIMH · Suspect Gene Variants Boost PTSD Risk after Mass Shooting).

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http://www.nimh.nih.gov/news/science-news/2011/suspect-gene-variants-boost-ptsd-risk-after-mass-shooting.shtml
Who is Affected?
Typically, when people think of Post-Traumatic Stress Disorder they think of war veterans. The truth is that PTSD can affect anyone who has been through a traumatic experience. As seen in the graph below, military veterans account for only about 30 percent of total PTSD occurrences.

PTSD Occurrence
PTSD Occurrence

http://tellaboutabuse.wordpress.com/tag/dissociative-identity-disorder/

As stated above, trauma effects different people in different ways. For example, people who are mentally prepared for a traumatic event (i.e. have prior knowledge of the likelihood that the event could occur and with that knowledge accept the risks in a situation) suffer less ill effects than those who are unprepared. There are both behavioral and cognitive components of psychological preparedness for trauma (Basoglu, 1997). One psychological study of torture victims showed fewer symptoms of Post-Traumatic Stress Disorder in a group of people who underwent more severe torture than a group that underwent less severe torture. The determining factor was the level of psychological preparedness. Those who underwent more severe torture were political activists and therefore aware of the possible consequences but accepting of them. The second group had no expectation of arrest or torture and suffered more symptoms of Post-Traumatic Stress Disorder (Basoglu, 1997).

Studies have also shown that the way individuals cope with trauma can be used as a predictor for the likelihood of PTSD development in said individuals (Schnider, 2007). Coping style can be influenced by many things, among them individual personality, preparedness, and outside support. One particularly relevant study, conducted on a group of 123 college students who had recently experienced the unexpected death of a loved one, found that the students who chose either problem-focused or active and avoidant emotional coping styles were at a higher risk for PSTD. With the use of path-analysis, however, it was found that only avoidant emotional coping was a predictor for PTSD (Schnider, 2007). The common sayings are true, avoiding the problem makes it worse.

Psychological preparedness and coping mechanisms aren't the only factors. Genetics and biology can play a role too. Women are twice as likely despite their less frequent exposure to trauma to develop PTSD than men (Bryant, 2011). The National Institute of Mental Health states that "college students exposed to a mass shooting were 20-30 percent more likely to later develop post traumatic stress disorder (PTSD) symptoms if they harbored a risk version of a gene, NIMH-funded researchers have discovered" (NIMH · Suspect Gene Variants Boost PTSD Risk after Mass Shooting). This particular gene is responsible for the control of serotonin recycling (NIMH · Suspect Gene Variants Boost PTSD Risk after Mass Shooting). Serotonin is a neurotransmitter that effects mood, sleep, and appetite (Ciccarelli, 2013).



IV. Coping with Trauma: Treatment & Recovery

Immediate After-Effects of Traumatic Experiences

The period of time directly following a traumatic event is crucial. New studies have raised the question of whether or not PTSD can be prevented. With so much evidence pointing to personality as a predictor, it's comforting to hear that it may not be unavoidable. Some evidence suggests that early intervention may be the key to preventing the development of PTSD. Biologically this makes perfect sense, as memories are most modifiable the more recently they have been formed. When memories of a traumatic experience are more firmly established, the feelings of guilt and helplessness are more difficult to overcome (Schore, 2001).

How do you know if you need help?

Not everyone who endures a traumatic event will need help in overcoming it, but how can people tell if their post-traumatic stress is normal or something more? Click download on the document below to see an example of a trauma screening questionnaire designed to inform people of whether or not their post-traumatic symptoms are normal or if they should seek outside help.




Moving on/Recovery

Trauma has serious lasting effects on people, particularly those who are more prone to PTSD. One study conducted solely on high-school age students demonstrated that experiencing or witnessing a violent traumatic event is directly related to the development of problems such as depression, anger, and other post-traumatic stress symptoms. The findings of this study supply evidence toward the necessity of providing adolescents with services to help them cope with traumatic events (Singer). Due to the rate of brain development, this study is perhaps even more applicable to college students than studies conducted on adults. The human brain continues to develop well the 20's (Ciccarelli, 2013). College students are not as prepared to handle trauma as other age groups, and yet they are at a higher risk of it (Clemans).

Benefits of Trauma

Most studies on trauma focus on the negative effects, ignoring any positives that may exist. When people think to question whether or not trauma can have positive effects, the answer is very often yes. Many studies have shown that most people who have undergone a traumatic event believe they benefited in some way from it. One study in particular, conducted at the university of Minnesota, found a strong correlation between trauma exposure and prosocial behavior. The more traumatic events someone had experienced, the more likely they were to engage in prosocial behavior (Frazier, 2013). Why does this happen? One hypothesis is that by helping others trauma survivors are able to control and decrease their own stress from their experiences. Prosocial behavior tendencies can manifest themselves in many ways. There are many examples of trauma survivors forming charity organizations, volunteering, and the like (Frazier, 2013). One study demonstrated that trauma survivors make up an estimated 30% of graduate students in helping professions (Shannon, 2013).



V. Conclusion/Response

After conduction all of the research seen above, I've come to the conclusion that, with the exception of the veteran population, trauma is more of an issue for college students than it is for the rest of the population in general. College students are still effectively children in that their brains are not fully finished developing, and yet they are expected to act and think as adults. The lack of sufficient research on student survivors of trauma makes it difficult for teachers to know how best to approach and help a student recovering from a traumatic event (Shannon, 2013), and I think that needs to change.


On a more positive note, the benefit of increased prosocial behavior raises the question if there are perhaps more benefits to undergoing trauma, and I believe there is. "What doesn't kill you makes you stronger." I think there's more to this than the tough-love parenting that it originated from. Hardship makes people stronger and more empathetic. Once we have the knowledge of how to prevent problems such as PTSD, I believe these benefits will be even more obvious.



VI. Motivation for Choosing this Topic

My goal after college is to go to graduate school and become a physical therapist. I hope that by researching and understanding how different people deal with trauma will help me to treat not only the physical injuries, but the mental ones as well. Many people need physical and psychiatric therapy after accidents, and I think it's very important for healthcare professionals to recognize this. As a physical therapist I hope to not only help my patients heal and overcome their physical injuries, but their mental ones as well. One doesn't have to be a therapist to help someone who is struggling, a basic knowledge of what they're going through and an eagerness to help can go a long way.



VI. References

Basoglu, M. (1997). Psychological preparedness for trauma as a protective factor in survivors of torture. Psychological Medicine, 27(06), 1421-1433. Retrieved from http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=25557

Bryant, R. (2011). Post-traumatic stress disorder vs traumatic brain injury. Dialogues in Clinical Neuroscience. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182010/


Cardena, E. (2005). Effects of traumatic stress on brain structure and function: Relevance to early responses to trauma. Retrieved from http://userwww.service.emory.edu/~jdbremn/papers/early%20responses.pdf

Ciccarelli, S. K., & White, J. N. (2013). Psychology: An exploration (2nd ed.). Upper Saddle River, N.J: Pearson.

Clemans, T. A. (n.d.). An Overview of Post-Traumatic Stress Disorder in the College Setting. Retrieved from http://www.mirecc.va.gov/visn19/docs/presentations/Overview_PTSD_College_Setting.pdf

D Fife, J I Barancik, and B F Chatterjee. Northeastern Ohio Trauma Study: II. Injury rates by age, sex, and cause. American Journal of Public Health May 1984: Vol. 74, No. 5, pp. 473-478. doi: 10.2105/AJPH.74.5.473

Hirini, P., Flett, R., & Long, N. (2005). Frequency of Traumatic Events, Physical and Psychological Health among Maori. New Zealand Journal of Psychology, 34(1), 20-27. Retrieved from http://www.psychology.org.nz/cms_show_download.php?id=623

Frazier, P., Greer, C., Gabrielsen, S., Tennen, H., Park, C., & Tomich, P. (2013). The relation between trauma exposure and prosocial behavior. Psychological Trauma: Theory, Research, Practice, And Policy, 5(3), 286-294. doi:10.1037/a0027255

Kira, I., Lewandowski, L., Somers, C. L., Yoon, J. S., & Chiodo, L. (2012). The effects of trauma types, cumulative trauma, and PTSD on IQ in two highly traumatized adolescent groups. Psychological Trauma: Theory, Research, Practice, And Policy, 4(1), 128-139. doi:10.1037/a0022121

NIMH · Suspect Gene Variants Boost PTSD Risk after Mass Shooting. (2011, December 1). Retrieved from http://www.nimh.nih.gov/news/science-news/2011/suspect-gene-variants-boost-ptsd-risk-after-mass-shooting.shtml

Schnider, Kimberly R.; Elhai, Jon D.; Gray, Matt J. Journal of Counseling Psychology, Vol 54(3), Jul 2007, 344-350. doi: 10.1037/0022-0167.54.3.344

Schore, A. N. (2001). The Effects of Early Relational Trauma on Right Brain Development, Affect Regulation, & Infant Mental Health. Infant Mental Health Journal, 22. Retrieved from http://www.trauma-pages.com/a/schore-2001b.php

Shannon, P. J., Simmelink, J., Im, H., Becher, E., & Crook-Lyon, R. E. (2013). Exploring the Experiences of Survivor Students in a Course on Trauma Treatment. Psychological Trauma: Theory, Research, Practice, And Policy, doi:10.1037/a0032715

Singer MI, Anglin T, Song L, Lunghofer L. Adolescents' Exposure to Violence and Associated Symptoms of Psychological Trauma. JAMA. 1995;273(6):477-482. doi:10.1001/jama.1995.03520300051036.