Life after the storm: The psychological response after trauma


by Evan Rainey, MS, CCRC

Mar 29, 2016

As victims and families begin to piece their lives back together after a tragedy, a new, lesser-known struggle may emerge.

Ann Marie Warren, PhD, ABPP, a clinical psychologist on the medical staff at Baylor University Medical Center at Dallas, and Jeff Quan, a counselor at Eastfield College, recently sat down for a segment of the KERA series “One Crisis Away: Rebuilding a Life” to discuss the psychological responses that may persist after a traumatic event, such as the storms that caused devastation to North Texas last winter.

Trauma is defined as a psychological or physical response formed by experiences and past events.


Trauma can often be accompanied by cognitive or mood changes, anxiety, isolation, hypervigilance, startled response, irritability, functional impairment, or inability to return to work or school. If these symptoms occur within the first 30 days of trauma, experts refer to this as Acute Stress Disorder. However, if these symptoms persist for longer than 30 days, a diagnosis of Post-traumatic Stress Disorder (PTSD) is made.

Trauma From Natural Disasters

“While natural disasters can be very traumatic, they don’t always have that emotional connection in the brain,” Dr. Warren said. “Research shows that more interpersonal traumas, man-made situations like an assault or shooting, tend to have greater psychological consequences. So the rates of PTSD may be much higher if you have been shot or stabbed, especially by someone you know, compared to experiencing a motor vehicle collision or a natural disaster.”

Dr. Warren’s research at Baylor University Medical Center at Dallas’ Level I Trauma Center has provided insight into the incidence and prevalence of PTSD in our patient population following a traumatic event, such as a gunshot wound or motor vehicle collision. A study examining psychological response in our trauma patients for one year following injury, reported rates of posttraumatic stress symptoms as high as 31 percent at the time of hospitalization and continuing in approximately 25 percent of our patient at one year post injury.


Many coping strategies exist for psychological stress following trauma, such as deep breathing and meditation, however, Dr. Warren recommends two popular, evidence-based practices used by the Veterans Health Administration and other institutions in the nation: prolonged exposure and cognitive processing therapy.

Prolonged exposure refers to the notion of re-experiencing the traumatic event through remembering it and engaging with, rather than avoiding, reminders of the trauma (triggers). Cognitive processing therapy aims to identify maladaptive thoughts related to the trauma and works to change those thoughts. The National Center for PTSD provides more information about PTSD treatment, including apps that individuals can use when symptoms arise.

Another, lesser known and more positive response to trauma is Post Traumatic Growth. This refers to the idea that trauma can have a positive impact on relationships and outlook on life and is also a topic of research at our trauma center.

“When patients, early on, start talking about purpose and meaning for their injury, it indicates to me that they are going to recover well.” —Dr. Warren

While trauma — such as a natural disaster or motor vehicle collision — can have a devastating effect on the lives of individuals involved, psychological responses to trauma can often be overlooked. It is important to understand these symptoms, their triggers and coping strategies. It is also crucial to be aware that life after trauma does exist and the opportunity for growth is present.

About the Author

Evan is Supervisor of the Trauma Research Center at Baylor University Medical Center at Dallas’ Level I Trauma Center. She graduated from Baylor University and completed her master’s thesis with the trauma department, before becoming a member of the team in 2014. She is currently working on her PhD in Health Studies at TWU.

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