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3.1 Identification and signs of possible trauma - what helpers should look out for
Aim . To identify signs that indicates that a survivor may be under serious strain .
HELP AND ACTION
In earlier chapters , we explained severe stress and trauma , and described how people exposed to it feel that they and the world are changed . We also described the reactions and symptoms that commonly follow such events . Stressed by sexual violence or abuse they experienced , they are stressed again if they flee from their country to another and must adapt to the challenges of settling in a new culture . Survivors often feel inferior , unable to cope , powerless , isolated , and burdened by shame . Much is unknown and uncertain , notably the future .
We also discussed the value of procedures to identify people in a situation of vulnerability when they first arrive in a new place of settlement . These procedures should create safe opportunities for conversation . We noted , however , that , even when reception arrangements are welcoming and professional , many survivors will be unable or unwilling to talk about painful intimate experiences . They may find it impossible but may also be afraid to open up , because they do not know how they will be treated in their new society .
In this early phase , helpers can use informal discussions , questionnaires , and trauma symptom checklists or guides to assess reactions and symptoms . 58 59 At the same time , injuries can now be documented systematically using the UN Manual for effective investigation and documentation of torture and ill-treatment ( updated in 2022 ), usually known as the Istanbul Protocol . 60 This is an internationally approved tool for assessing and documenting torture . 61
3.1.1 Signs of possible trauma in adults
A single sign does not imply trauma but several signs that occur simultaneously might do so . 1 . Sleep problems . 2 . Aggression . 3 . Restlessness . 4 . Anxiety . 5 . A constant “ on guard ” attitude . 6 . Being alarmed or disturbed by seemingly trivial events ( triggers ). 7 . Huge mood swings . 8 . Difficulty regulating emotions and behaviour . 9 . Eating problems . 10 . Social withdrawal . 11 . Severe concentration problems . 12 . Problems of memory . 13 . Self-medication ( intoxication ). 14 . Uncontrolled and outspoken behaviour .