English Mental health and gender-based violence English version | Page 141

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PART III : THEORY
The following factors may make it more likely that a survivor will develop severe PTSD :
• The experience is severe , such as a disaster or a war . The amount of exposure is relevant . Multiple incidents are more likely to trigger PTSD than a single episode of violence .
• A trauma stretches over time and the survivor lives permanently in danger or fear .
• The victim is a woman or a girl . Women and girls may face extra pressure because they must care for children or because they are more sensitive to relationships .
• The victim is a child . Children generally show more distress after catastrophes than adults . Children also recover with more difficulty if their parents are stressed .
• The survivor is injured , or sees other people killed or hurt ; or experienced loss of control and helplessness , or felt extreme panic and fear .
• She receives little or no social support . After a traumatic experience , it is important to ensure that survivors are not left isolated without care , or receive no assistance to help them deal with the aftermath of a catastrophe .
• She has no support group .
• She has to deal with other things in addition to the catastrophe : the loss of loved ones , injury or physical pain , the loss of home or income .
• She suffered from mental problems before the traumatic event occurred . If she had previously experienced domestic violence , for example , this might have depressed her self-esteem or capacity to manage stress .
• Her community is in recovery . This can take some time and tends to deprive survivors of critical personal support .
The same factors are relevant to people who have a close association with survivors of trauma , such as witnesses , relatives and helpers .
Coping skills can be understood as resources that are available and that the person is capable of utilising in challenging situations .
The most important coping skills can be summarised by the acronym BASIC-Ph ( Lahad 1993 ). B Belief and value system . A Affect regulation . S Social support available and capacity to utilise it . I Imagery : symbols , play and art . C Cognition , understanding of the inner and outer world . Ph Physical : breathing , relaxation and building strength .
Concluding comments
Most people show strong reactions to serious and dangerous events when these happen , and their response continues for some time after the event ( 1-3 months ). We have called these ‘ acute stress reactions ’. Such reactions diminish over time , within months for many , within years for some , depending on the severity of the event and the resilience of the person . Some people experience delayed trauma reactions . Some may develop persistent disorders , such as chronic stress disorder ( chronic PTSD ), long term depression , or anxiety disorders . See http :// www . hhri . org / thematic / ptsd . html ; and Dickstein , Suvak , Litz , and Adler ( 2010 ).