Repeated Trauma Increases Adjustment Difficulties after Subsequent Trauma

“Those who have experienced multiple traumas are more likely to develop posttraumatic stress disorder (PTSD) than those who have had a single traumatic experience, and there appears to be a linear relationship between the number of traumas experienced and an individual’s risk for PTSD,” said researchers of a recent study. “Experiencing multiple traumas has also been associated with a greater risk of depression than experiencing a single traumatic event.” Because of this, it is unclear whether distressed individuals are more vulnerable to traumatic symptoms or whether being subjected to repeated traumatic events causes elevated levels of distress.

To determine the relationship between the two, a team of researchers enlisted 215 women from a sexual victimization study, who were students at Virginia Tech prior to the shooting in 2007. Of the participants, nearly 35% had been sexually victimized as an adult or teen, and nearly 25% had been sexually abused as a child. Almost all of the participants had been directly exposed, either moderately or severely, to the shooting in April of 2007. The researchers evaluated social support and depression levels in the women before the shooting, two months after and again after one year. At two months after the shooting, the women who had been sexually victimized reported lower levels of family support and benevolence. “Although victims of sexual trauma and non-victims of sexual trauma reported similar levels of distress prior to the campus shooting and in the immediate shooting aftermath, sexual trauma victims had significantly poorer adjustment one year following the shooting, reporting elevated depressive and PTSD symptoms,” said the team. The findings have implications for treating people who experience a mass trauma, in particularly, those who have had multiple prior traumatic experiences. The researchers added, “This suggests the possibility that multiple trauma victims may be less able to respond adaptively to the challenge to their own worth presented by a new traumatic experience, perhaps in part because they are more likely than single trauma victims to experience persistent distress.

Littleton, H. L., Grills-Taquechel, A. E., Axsom, D., Bye, K., & Buck, K. S. (2011, August 29). Prior Sexual Trauma and Adjustment Following the Virginia Tech Campus Shootings: Examination of the Mediating Role of Schemas and Social Support. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. doi: 10.1037/a0025270

© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Rita


    September 8th, 2011 at 12:26 PM

    Sometimes you can simply look at someone and know that they have been hurt in their lives and that the trauma is ruining who they are what they could be. It is sad to think that someone has had to experience one traumatic experience like this, much less numerous times. Makes you stop to think just how grateful many of us should be for the lives that we have been allowed to live relatively trauma free.

  • "E" Cooper

    September 8th, 2011 at 4:21 PM

    My theory, if you are willing to hear me out, is that this happens because while experiencing a second or third (or even more) traumatic event they relate it to the previous one(s) that they have experienced.

    This could cause them to become even more stressed out since for many people a past traumatic event being brought up is enough to panic them, never mind it being a reality once again.

    The more traumatic events these people are being exposed to, the more likely they will breakdown seems to make sense to me. Anyway that is just my opinion if anyone cares! ;-( Tell me what you think, I’m a way off or what?

  • G. M. Cowan

    G. M. Cowan

    September 8th, 2011 at 6:51 PM

    Of course you’ll be more likely to have PTSD if you are suffering from trauma for the umpteenth time in your life. To say that someone who gets into a car accident has the same odds of having PTSD as someone who has been subject to terrorist attacks, hit by a car, mugged in the street, and a victim of rape is beyond the realm of commonsense. It’s logical that they would be more at risk.

  • rachel h

    rachel h

    September 8th, 2011 at 7:11 PM

    going through a trauma and the after-effects is bad enough, to experience another or many others is just disastrous. the second or any subsequent traumatic event is not only a trauma in itself but it will also remind the victim of any preceding traumatic events and they can all come down upon the victim like a pile of bricks!

  • ws


    September 8th, 2011 at 7:41 PM

    My heart goes out to those that are so unlucky that they have had to handle multiple traumas. No matter how hard you try, short of attaching cameras on every single person in the country, crime will still happen. So will other events that are traumatic in their nature like natural disasters, walking in on a suicide and so on.

    In an ideal world PTSD wouldn’t be a problem we need to handle but this is not an ideal world.

  • seanmcconnachie


    September 9th, 2011 at 7:04 PM

    Don’t forget too that one trauma is not equal to another either in its severity,and no-one can say for sure in the long run which types of trauma are more likely to trigger PTSD in the future.

    For example, sexual abuse is more damaging because of the psychological trauma more than the physical generally is it not? However if you were shot multiple times in a school shooting, the immediate trauma that’s more damaging is the physical trauma and the psychological trauma will surface later.

    If you’ve suffered both, how can they know which is the culprit in setting off the PTSD?

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