Academic journal article Canadian Journal of Behavioural Science

The Effect of Initial Trauma Exposure on the Symptomatic Response to a Subsequent Trauma

Academic journal article Canadian Journal of Behavioural Science

The Effect of Initial Trauma Exposure on the Symptomatic Response to a Subsequent Trauma

Article excerpt


The effect of initial trauma on the symptomatic response to a subsequent trauma was investigated in a cross-- sectional study of urban bus drivers. Comparisons were made among 175 drivers who had developed either high or low symptoms of post-traumatic stress disorder (PTSD) as a result of the initial trauma, and a third group exposed to only a single trauma. The group with high levels of PTSD symptoms after the initial trauma reported high PTSD symptoms for a subsequent trauma (75%) significantly more often than the other two groups who did not differ from each other (Low PTSD symptoms group 49%, No prior trauma group 41%). These results suggest that unless trauma exposure leads to significant PTSD symptoms, it is not a risk factor for high PTSD symptoms after exposure to a subsequent traumatic event.


L'effet du traumatisme initial sur la reaction symptomatique A un traumatisme subsequent a ete examine dans le cadre d'une etude transversale de conducteurs d'autobus en milieu urbain. Des comparaisons ont ete faites entre 175 conducteurs qui etaient atteints de symptomes aigus ou faibles du syndrome de stress post-traumatique (SSPT) a la suite d'un traumatisme initial et d'un troisieme groupe expose a un soul traumatisme. Le groupe atteint de symptomes aigus du sstr apres le traumatisme initial a manifesto des symptomes de SSPT aigus pour un traumatisme subsequent (75 %) considerablement plus souvent que chez les deux autres groupes qui ne differaient pas Fun de l'autre (49 % pour le groupe A faibles symptomes de SSPT, 41 % pour le groupe sans traumatisme subsequent). Ces resultats sugge rent qu'a moins que l'exposition a un traumatisme ne provoque des symptomes de SSPT significatifs, elle ne represente pas un facteur de risque de symptomes de SSPT aigus apres l'exposition a un evenement traumatique subsequent.

According to a recent epidemiological survey of the American population, half of the 56% reporting any lifetime trauma exposure have actually encountered such events more than once (Kessler, Sonega, Bromet, Hugues, & Nelson, 1995). Although there is a growing body of literature on the effects of frequency of exposure to trauma, no clear consensus has emerged, with one view being that multiple exposures promote moderate resilience to the effects of subsequent exposures and the other suggesting multiple exposures increase risk of problems such as post-traumatic stress disorder (PTSD). PTSD is a pathological response to the experience of a life-threatening event. Symptoms of PTSD include intrusive thoughts, various forms of avoidance, numbing, and hyperarousal that interfere substantially with normal functioning.

Studies of emergency personnel typically illustrate the hypothesis that resilience can follow multiple trauma exposures. Although there are exceptions (e.g., Corned, Beaton, Murphy, Johnson, & Pike, 1999), several reports indicate that experienced rescue workers (Weiss, Marmar, Metzler, & Ronfeldt, 1995) and fire fighters (Hytten & Hasle, 1989) have lower rates of post-traumatic stress symptoms (PTSS) or diagnosis (PTsD) than their inexperienced peers. However, it may be that selection, training, or age can mitigate the impact of being repeatedly exposed to traumatic events. One line of research that does not suffer from such confounds involves individuals exposed to community disasters (Quarantelli, 1985; Solomon, 1995). Unfortunately, the surveyed populations in disaster research have not always met the exposure criterion as operationalized in the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association [APA], 1987, 1994). This casts doubts on the generalizability of such findings to more severely exposed groups.

Another body of research suggests that repeated traumatic exposure lead to increased problems. This has been found in the general population (Breslau, Chilcoat, Kessler, & Davis, 1999) as well as in specific trauma groups such as physical and sexual assault victims (Arata, 1999; Follette, Polusny, Bechtle, & Naugle, 1996), refugees (Goenjian, Najarian, Pynoos, & Steinberg, 1994) and war veterans (King, King, & Foy, 1996). …

Search by... Author
Show... All Results Primary Sources Peer-reviewed


An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.