Trauma results from an event that a person sees as harmful or life-threatening and that affects mental, physical, social, emotional, or spiritual well-being, like the sudden, unexpected death of a loved one, or a gunshot or stab wound. Sometimes people experience lasting distress from trauma – Post-traumatic Stress Disorder (PTSD).
For example, people who have been through trauma may experience
- Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
- Bad dreams
- Avoiding thoughts or feelings related to the traumatic event
- Having difficulty sleeping
- Having angry outbursts
Counseling can help people understand these painful emotions and the triggers for them, and reduce the distress of PTSD. Counseling services reduce the risk someone who has been through trauma will retaliate or be re-injured.
Violence is a recurrent problem
Without intervention, up to 41 percent of people injured by assault will be reinjured within five years. Up to 20 percent of patients treated for violent injury will be killed within five years. The Hospital-based Violence Intervention Program (HVIP) – which provides services to violently-injured people entering Emergency Departments with was inspired by the story of “Jason”
In 1988, when he was only nine years old, Jason was treated in the emergency department of Children’s Hospital in Milwaukee for an “accidental” injury. Two years later, the hospital treated him again for multiple contusions and abrasions resulting from an assault. In 1992, at 13 years of age, he was treated for multiple stab wounds. Then, in early 1994, at the age of 15, the hospital treated Jason for a bullet wound to his leg. By the end of that year, he was dead—shot in the chest and killed at the age of 16. While medical staff expertly cared for his physical wounds each time, not once were his community health needs and risk factors addressed post-discharge.
A significant share (from 15% to 75%, depending on the study) of people treated for violent injury develop PTSD, depression, or substance-abuse disorders that put them at risk for re-injury. People with a history of childhood trauma are especially at risk for PTSD after an assault.
The Connection Between Trauma, Adverse Childhood Experiences (ACEs) and Violence
Between 1995 and 1997, the Center for Disease Control (CDC) and Kaiser Permanente (a large HMO) surveyed over 17,000 mostly white, mostly college-educated, middle class adults with good health insurance and measured how many people had experienced abuse, neglect, or household challenges in childhood – Adverse Childhood Experiences, or ACEs.
They found that the higher the ACEs score, the higher the risk of experiencing negative health consequences later in life.
To see the original ACE questionnaire and find out your own score, click here.
Here are some examples of the relationships the original study found between childhood ACE scores and the risk of health problems in adulthood.