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Trauma Survivor Stigma refers to negative attitudes or beliefs towards individuals who experienced a psychological trauma. Trauma survivor stigma may be manifested in many forms and may appear different for various populations. The stigma can be categorized in 2 broad categories: social stigma and personal stigma. Social stigma refers to a negative attitude or belief a collective population holds against a group. Personal stigma is when an individual perceives a society or community holds a negative attitude or belief against them based on a particular characteristic or inclusion in a group. Trauma survivors commonly cite social stigmas as society thinking they are “weak” or “the victim is at least partially at fault,” as well as “they are violent and unpredictable.” Many of the personal stigmas individuals with PTSD may have are “people will think I’m weak” or “no one will believe me.” These stigmas, along with others, may function as a barrier to individuals seeking treatment.

Social Stigma Social Stigma of trauma refers to the negative attitudes and beliefs a society has about individuals who have experienced a traumatic event. These attitudes and beliefs are predominantly utilized to marginalize this population. Although some social stigma may not be overtly intended to marginalize survivors, institutional policies or social reactions may portray negativity. Common examples of social stigma include the discharge from the military due to behaviors associated with PTSD among service members, or a belief held that a victim of sexual assault could have prevented an incident by altering behaviors or appearances. Both instances decrease the likelihood the individual will not seek necessary treatment.

Personal Stigma of PTSD refers to the negative attitudes and beliefs an individual holds about themselves based on their symptoms and/or diagnosis of PTSD. Personal stigma is correlated with help seeking behaviors and is often cited as a primary reason for not seeking help when it is needed. Common narratives associated with personal stigma are “I’m am weak,” and “I should be able to take care of my own problems.” Other narratives include “No one will believe my story anyways.” These beliefs may be derived from actual experience or experience of others, as well as the individual’s beliefs about their trauma. A person’s cultural conception of what it means to be a victim plays a crucial role in how the individual perceives their experiences as well. Individuals carrying personal stigma may experience a vast array of emotions such as shame and guilt, as well as self-blame.

Military Veterans and Combat Trauma Stigma Among veterans involved in Operation Iraqi Freedom or Operation Enduring Freedom (OIF/OEF), approximately 11 to 20% of individuals will have PTSD in a given year. In 2008, approximately 20% of individuals returning from Iraq and Afghanistan experienced some form of mental health related issues, where approximately 50% of these aforementioned individuals sought mental health services. Social and personal stigma can contribute to service members and veterans not seeking mental health services for traumatic stress symptoms. Previous policies, such as disclosing whether a service member sought mental health services was required when applying for a security clearance. This form of reporting would require additional investigation to that service member and could negatively influence their career. Along with policy implications, social stigma is also manifested through cultural values. U.S. military culture promotes strengths and values resiliency and adaptability, as is often cited as a U.S. Marine mantra “Improvise, adapt, and overcome.” Many service members and veterans may feel their concession to having a mental illness is contradictory to this cultural expectation. Personal stigmas held by service members and veterans allude to the idea that individuals who have combat related PTSD are “crazy” or “violent.” A predominant reason service members and veterans give to not seek treatment is avoidance of these aforementioned labels. Other service members cite reluctance to seek services or disclose their symptoms to others as a result of the influence of social stigma. Given the cultural values of strength, many veterans hold personal negative beliefs about their personal strength, which enables a personal stigma of being “weak” due to their perceived inability to cope with trauma symptoms.

Sexual Assault Victim Stigma According to the Bureau of Justice Statistics in 2016, approximately 23% of rape or sexual assaults were reported to police or local law enforcement, which was the lowest reported violent crime. Social and personal stigma can influence a victim’s decision to not report in efforts to avoid social stigma. One type of social stigma associated with sexual assault victim stigma is the social phenomenon called victim blaming. This is when a societal belief exists that the victim could have altered their behavior or appearance to avoid such assaults against them. Other examples of social stigma include the belief that victims lie during testimony. This stigma contributes to the underreporting of sexual assaults and can lead to victim isolation. Personal stigma associated with sexual assault survivors may result for the aforementioned social stigmas. When an individual files a report of sexual assault, it is possible the proceeding investigation will intrude the victim’s privacy and delve into their personal life. This invasive process may question the victim’s character, leading the victim to believe these accusations. Victims often place blame on themselves and develop negative beliefs about themselves as a result of the assault.

PTSD & Stigma Experiencing a traumatic event may lead some victims to develop Post-Traumatic Stress Disorder. The DSM 5 indicates a prevalence rate of approximately 3.5% in the United States. Rates are significantly higher in military and veteran populations as well as females. This is due to these populations at greater risk for exposure to trauma. PTSD has been referred to as “invisible scars” of trauma in reference to the notion of emotional distress not visible to others. According to the National Institute of Mental Health, the 12-month prevalence rate for women was 5.2% whereas males had a prevalence rate of 1.8%. Armed forces service members and veterans.

Efforts to break stigma There have been many social and organizational movements aimed at breaking the stigma surround trauma survivors. With a high prevalence of PTSD in OIF/OEF veterans, the Department of Defense as well as the Department of Veterans Affairs have provided education about psychological trauma to encourage more service members to seek mental health services. In 2017, after sexual assault allegations surfaced against movie producer Harvey Weinstein, a social movement named the Me Too movement started as a means to empower sexual assault victims and raise awareness to the reporting disparity. Additionally, college campuses provide education regarding sexual assault such as defining sexual assault for students, debunking common myths about sexual assault, and providing support to victims. These efforts are designed to reduce social stigma among larger communities, as well as provide the education necessary to help reduce the personal stigma of victims.