Preexisting Conditions Affecting Psychological Trauma

When you ask the question is my client more vulnerable than others to a given trauma, you are asking a complicated question. Other things being equal, individuals with severe mental disorders are at the top of the list of those most vulnerable. This would include schizophrenics, major depressive disorders, and borderline personality disorders.

Vulnerability must be determined on a case-by-case basis by obtaining a case history of the individual and assessing the type and degree of stress he/she has encountered. As an example, most of us would be symptomatic if we encountered a major stressor such as a natural disaster or a death of a loved one. On the other hand, we would tend to have a variety of individually determined reactions to such events as accidents, robberies, assaults, or product failure. Consider the example of two women, each of whom has been the victim of an assault. One has been raised by harsh, moralistic, and rejecting parents and has a history of child abuse. The other is from an affectionate, warm, and accepting family with no history of child abuse. Who is most likely to suffer severe psychological trauma?

Thus, we  need to take a thorough developmental history of the client. We then need to collect objective evidence of a preexisting condition. Then we need to complete a psychological assessment with a battery of relevant tests to examine the current psychological condition. We would be especially interested in how our client incorporates the negative event into their world view. Individuals that accept the fact that “bad things can happen to good people”, tend to be less traumatized than individuals whose diagnosis causes them to view the world as unfair or random.