2.2 Recognizing signs and symptoms of trauma in survivors and witnesses

Trauma survivors and witnesses often exhibit physical, emotional, and behavioral signs that can be challenging to recognize. From headaches and anxiety to avoidance and hypervigilance, these symptoms can significantly impact daily life. Understanding these signs is crucial for journalists covering traumatic events.

Interviewing trauma survivors requires creating a safe, supportive environment and being mindful of their emotional state. By using active listening skills, asking open-ended questions, and offering breaks, journalists can help survivors share their stories while minimizing potential re-traumatization.

Trauma Signs in Survivors

Physical and Emotional Indicators

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  Complex Posttraumatic Stress Disorder (C-PTSD) symptoms and diagnostic criteria View original

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  Trauma and Abuse including Type 1 and Type 2 (often cause of Complex trauma) View original

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  Complex Posttraumatic Stress Disorder (C-PTSD) symptoms and diagnostic criteria View original

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• Physical symptoms exhibited by trauma survivors (headaches, fatigue, muscle tension, gastrointestinal issues, changes in sleep patterns or appetite)
• Emotional signs of trauma
  • Fear, anxiety, sadness, anger, guilt, shame
  • Emotional numbness or detachment
• Cognitive symptoms manifesting as intrusive thoughts, flashbacks, difficulty concentrating, memory problems
• Distorted beliefs about oneself, others, or the world (self-blame, loss of trust, feeling permanently damaged)

Behavioral Changes and Psychological Impact

• Avoidance of trauma reminders (people, places, or situations associated with the traumatic event)
• Social withdrawal and isolation from others
• Hypervigilance and heightened startle response
• Irritability, anger outbursts, or aggressive behavior
• Engaging in risky or self-destructive behaviors as a coping mechanism (substance abuse, reckless driving, self-harm)
• Sense of helplessness, loss of control, or a shattered sense of safety and trust in the world

Challenges for Trauma Witnesses

Secondary Traumatic Stress and Moral Dilemmas

• Witnesses experiencing secondary traumatic stress or vicarious trauma, leading to symptoms similar to direct trauma survivors
• Feelings of guilt, helplessness, or a sense of responsibility for not preventing or intervening in the traumatic event
• Moral dilemma of whether to share their account, fearing judgment, disbelief, or potential legal implications (testifying in court, facing cross-examination)
• Pressure or expectations to provide detailed, accurate accounts of the event, challenging due to trauma's impact on memory and perception

Shattered Worldviews and Coping Difficulties

• Witnessing trauma challenging an individual's worldview and belief in a just world
  • Loss of faith in humanity or the goodness of others
  • Questioning one's own values, beliefs, or purpose in life
• Difficulty processing and making sense of the traumatic event, leading to rumination or obsessive thoughts
• Strained personal relationships due to others' lack of understanding or the witness's emotional unavailability
• Struggling to find effective coping strategies to manage the emotional impact of witnessing trauma

Acute Stress vs PTSD

Timeframe and Symptom Persistence

• Acute stress reactions occurring immediately after trauma, lasting days to weeks
• PTSD as a long-term condition persisting for months or years
• Symptom overlap between acute stress and PTSD, but PTSD characterized by persistence and severity beyond initial stress response period
• Acute stress as a normal response to an abnormal event; PTSD as a maladaptive response interfering with daily functioning

Diagnostic Criteria and Risk Factors

• PTSD diagnosed when intrusive symptoms, avoidance, negative cognition/mood changes, and hyperarousal persist >1 month post-trauma
  • Intrusive symptoms (flashbacks, nightmares, distressing memories)
  • Avoidance of trauma reminders (thoughts, feelings, people, places)
  • Negative alterations in cognition and mood (detachment, persistent negative beliefs, inability to experience positive emotions)
  • Hyperarousal (irritability, hypervigilance, exaggerated startle response, sleep disturbances)
• Most individuals with acute stress recover naturally; subset may develop PTSD
• Risk factors for PTSD: prior trauma history, lack of social support, pre-existing mental health conditions

Interviewing Trauma Survivors

Creating a Safe and Supportive Environment

• Establishing a safe, private, and comfortable setting for the interview
• Building rapport, explaining the interview's purpose, and obtaining informed consent
• Using active listening skills (eye contact, open body language, allowing uninterrupted sharing)
• Asking open-ended, non-leading questions to elicit the survivor's account in their own words
• Responding with empathy, validation, and support, acknowledging the difficulty of sharing

Pacing and Emotional Considerations

• Offering breaks as needed and attending to signs of distress
• Allowing the survivor to set the pace and take control of the interview process
• Being prepared for emotional reactions and providing appropriate support
• Providing information about available support services (counseling, victim advocacy)
• Offering to make referrals to support services if desired by the survivor or witness