Brief presentations of information on
aspects of PTSD:
Warning signs of trauma-related stress,
from Los Angeles County Department of Mental Health.
Signs from APA
Warning signs of trauma-related stress,
from the American Psychological Assn.
You are not alone! description of normal emotions following a disaster,
from the American Red Cross.
CENTER FOR PTSD
Research and Education on Post-Traumatic
PTSD and Community
A National Center
Community violence can take many forms: riots, sniper
attacks, gang wars, drive-by shootings, and workplace assaults. On a larger
scale, terrorist attacks, torture, bombings, war, ethnic cleansing, and
widespread sexual, physical and emotional abuse can affect entire populations.
Natural disasters can be traumatic, but community violence has several
unique features that can lead to a lingering and devastating traumatic
- Sometimes in natural disasters people have time to
prepare themselves, but community violence usually happens without warning
and comes as a sudden and terrifying shock.
- Natural disasters can force people to leave their homes
and friends, but community violence can permanently destroy entire neighborhoods
and end friendships -- or make the neighborhood or the relationships
too unsafe to trust and continue.
- Natural disasters are uncontrollable and unpreventable,
but community violence is the product of people's actions. Even though
most survivors of community violence are innocent victims, they may
feel guilty, responsible, self-blaming, ashamed, powerless, or inadequate
because they wish they could have prevented the violence even though
it was beyond their control.
- The damage caused by natural disasters is accidental.
Community violence involves terrible harm done on purpose, which can
lead survivors to feel an extreme sense of betrayal and distrust toward
Being victimized by violence leads some individuals to
react with violence, but there is no evidence as yet that survivors of
community violence who have PTSD are more prone to perpetrating community
violence than survivors who do not have PTSD. While PTSD does not cause
violence, PTSD symptoms can lead survivors of community violence to have
difficulty managing violent feelings or impulses. For example, people
with PTSD due to witnessing or being directly exposed to community violence
- Very disturbing memories and feelings of reliving the
- Flashbacks or nightmares, in which they unintentionally
act violently in order to protect themselves.
- Feeling indifferent to their own or other people's
suffering because they feel emotionally numb and cut off from others.
- Increased arousal, startle responses, and hypervigilance
(feeling extremely on-guard or in danger).
- Feelings of betrayal and anger from being exposed to
violence in what should be their "safe haven."
Most people exposed to community violence, with or without
PTSD, do not act violently. The stereotype of the violence survivor being
out of control and hell-bent on revenge or "payback" is a myth
that rarely occurs in real life. Severe day-to-day stressors that are
demoralizing, but not life-threatening, appear to play a greater role
-- both in causing community violence in general and in leading individuals
to act violently -- than PTSD or even traumatic violence itself. Research
suggests that violence is somewhat more likely in those communities whose
people live in highly stressful circumstances such as the following:
- High unemployment rates
- High rates of illegal drug use
- High rates of school drop-outs
- Chaotic, disorganized, or physically and emotionally
abusive families or classrooms
- Periods of extremely hot weather
Perhaps the greatest danger of violence associated with
PTSD occurs when community violence spills over onto the family and home,
especially in intimate relationships. No studies yet have determined whether
there is a link between community violence and domestic violence, but
this is a possibility that scientists and clinicians take very seriously,
because of a growing awareness that domestic violence is more common and
more devastating than previously realized.
Survivors of community violence struggle with many vital
- How to build trust again (issues of power, empowerment
- Seeking meaning in life apart from revenge or hopelessness
- Regaining trust versus being trapped in feelings of
guilt, shame, powerlessness, and doubt
- Finding realistic ways to protect themselves, their
loved ones, and their homes and community from danger.
- Healing traumatic losses and putting memories of violence
to rest without trying to avoid or erase them
- Commitment or recommitment to life (choosing life versus
giving up or seeking escape through suicide)
Rapid, timely, and sensitive care for the community as
well as for affected individuals and families is the key to preventing
PTSD in the wake of violence (and of reducing violence itself). Mental
health professionals with expertise in community violence can contribute
in several ways:
- Helping community leaders to join together to develop
violence prevention and victim assistance programs.
- Helping religious, educational, and health care leaders
and organizations to set up relief centers and shelters.
- Providing direct psychological services near the site
of violence. These might include debriefing survivors, supervising a
24-hour crisis hotline, and identifying survivors or bereaved family
members who are at high risk for developing PTSD (and helping them to
get connected with appropriate continuing treatment, to either prevent
or recover from PTSD).
- Providing education, debriefing, and referrals for
affected children at their schools, often working with teachers.
- Providing organizational consultation to government,
business, and healthcare programs affected by the violence.
- Sandra Burge, "Violence Against Women,"
Primary Care 24(1): 67-81 (March 1997).
- Dante Cicchetti and Michael Lynch, "Toward
an Ecological/Transactional Model of Community Violence and
Child Maltreatment:Consequences for Children's Development,"
Psychiatry 56(1): 96-118 (February 1993) .
- Richard L. Hough, et al., "Mental Health
Consequences of the San Ysidiro McDonald's Massacre:A Community
Study," Journal of Traumatic Stress 3(1): 71-92
- Aphrodite Matsakis, Post-Traumatic Stress
Disorder: A Complete Treatment Guide (Oakland, California:
New Harbinger Publications, 1994; ISBN 1-879237-68-7)