How Does Trauma Exposure Affect Thoughts, Emotions, and Behaviors?

What you need to know

• Trauma exposure is very common and can lead to changes in how people view themselves and the world
• Trauma can make it harder for people to manage their emotions effectively
• Those exposed to trauma may be more likely to engage in risky or self-destructive behaviors
• Addressing negative self-views and improving emotion regulation skills may help reduce the negative effects of trauma

How common is trauma exposure?

Experiencing traumatic events is unfortunately very common. Studies show that up to 70% of people report being exposed to at least one traumatic event in their lifetime, with about 30% experiencing four or more traumatic events. Trauma exposure is so widespread that it is considered a major public health issue.

Some examples of traumatic events include:

• Experiencing or witnessing violence
• Sexual abuse or assault
• Serious accidents or injuries
• Natural disasters
• Combat exposure
• Sudden, unexpected death of a loved one

In this study, over 85% of participants reported exposure to at least one traumatic event, with 66% experiencing multiple types of trauma. The most commonly reported traumas were:

• Unexpected death of someone close (49%)
• Witnessing domestic violence as a child (41%)
• Witnessing accidents, fires, or explosions (28%)
• Being in serious danger of death or injury (25%)
• Childhood emotional abuse or neglect (25%)

How does trauma affect people?

Experiencing trauma, especially multiple traumas, can have wide-ranging effects on a person’s thoughts, emotions, and behaviors. This study looked at three main areas that can be impacted by trauma:

1. Assumptions about oneself and the world
2. Ability to manage emotions effectively
3. Engagement in risky or self-destructive behaviors

Let’s explore each of these areas in more detail.

Changes in beliefs about oneself and the world

One way that trauma can affect people is by changing their core beliefs or assumptions about themselves and the world around them. The researchers looked at three types of beliefs that can be impacted:

1. Benevolence of the world - beliefs about whether the world is generally a good, safe place with good people
2. Meaningfulness of the world - beliefs about whether things happen for a reason and whether we have control over outcomes in our lives
3. Self-worth - how we view ourselves and our own value

They found that people who experienced more trauma tended to have more negative views, especially related to the benevolence of the world and their own self-worth. In other words, trauma exposure was associated with seeing the world as less safe/good and viewing oneself more negatively.

Importantly, having more negative beliefs about one’s own self-worth was linked to experiencing more trauma symptoms. This suggests that how we view ourselves after trauma may play a key role in whether we develop ongoing difficulties.

Difficulties managing emotions

Another area impacted by trauma is emotion regulation - our ability to effectively manage our emotions. The researchers looked at several aspects of emotion regulation, including:

• Accepting emotions
• Controlling impulsive behaviors when upset
• Engaging in goal-directed behavior when distressed
• Accessing effective strategies to regulate emotions
• Being aware of and understanding emotions
• Having emotional clarity

They found that people with more trauma symptoms tended to have greater difficulties across all of these emotion regulation domains. Two areas seemed especially important:

1. Difficulty controlling impulsive behaviors when upset
2. Lack of access to effective emotion regulation strategies

Problems in these areas were linked to engaging in more risky and self-destructive behaviors. This suggests that after trauma, some people may have a hard time managing strong emotions without acting impulsively or destructively.

Engagement in risky behaviors

The third major area examined was engagement in risky or self-destructive behaviors. This included things like:

• Substance use
• Self-harm
• Aggression
• Gambling
• Impulsive eating
• Risky sexual behavior
• Reckless behavior (e.g. drunk driving)

The researchers looked at both lifetime engagement in these behaviors as well as engagement in the past month. They found that people who experienced more trauma and had more trauma symptoms were more likely to engage in risky/self-destructive behaviors, both over their lifetime and recently.

Importantly, difficulty controlling impulsive behaviors when upset seemed to play a key role in recent engagement in these risky behaviors. This supports the idea that some people may use risky behaviors as a way to cope with strong emotions after trauma, especially if they struggle to control impulses when distressed.

How do these factors work together?

The researchers proposed a model for how all of these factors may work together:

1. Trauma exposure leads to changes in beliefs about oneself and the world, especially decreased self-worth
2. These negative beliefs contribute to experiencing more trauma symptoms
3. Trauma symptoms make it harder to regulate emotions effectively
4. Difficulties regulating emotions, especially controlling impulses, lead to more engagement in risky/self-destructive behaviors

They found support for this model in their data. Trauma exposure had both direct and indirect effects on symptoms and risky behaviors. Negative self-worth and emotion regulation difficulties helped explain the links between trauma, symptoms, and risky behaviors.

What are the implications?

This research highlights several important points about the effects of trauma:

1. Trauma is very common and can have wide-ranging impacts on thoughts, emotions, and behaviors
2. How we view ourselves after trauma may play a key role in whether we develop ongoing difficulties
3. Trauma can make it harder to manage emotions effectively, which may lead to risky behaviors
4. Addressing negative self-views and improving emotion regulation skills may help reduce the negative effects of trauma

The findings suggest some potential areas to focus on when helping people who have experienced trauma:

• Working to rebuild more positive views of oneself and one’s self-worth
• Developing skills to better manage strong emotions, especially controlling impulsive urges when upset
• Finding healthier ways to cope with distress besides risky or self-destructive behaviors

Early intervention may be key to prevent the cascade of negative effects that can occur after trauma exposure. Public health approaches to reduce trauma exposure in the first place are also important.

Conclusions

• Trauma exposure is very common and can lead to changes in thoughts, emotions, and behaviors
• Negative views of oneself seem to play a key role in developing ongoing trauma symptoms
• Difficulty managing emotions, especially controlling impulses when upset, may lead to more risky behaviors
• Addressing negative self-views and building emotion regulation skills are promising areas for intervention after trauma