There is no certain way of predicting who will cope successfully or otherwise after a traumatic experience.  However, the following factors increase the likelihood of the survivor having difficulties. 

• Serious physical injury. (It is worth remembering that the "seriousness" of an injury may be seen by the survivor not in terms of the amount of the physical damage but in terms of its personal psychological meaning.  For example, this may occur if the injury is particularly disfiguring to the hands or face or if it prevents the person from doing things they previously enjoyed doing.)
  
  
• Previous mental or emotional health problems.
  
  
• Particularly severe immediate reactions to the trauma, for example, numbness, shock and denial.
  
  
• A particularly anxious or insecure personality.
  
  
• A lack of social and/or family support.
  
  
• Current additional problems and stresses (e.g., health, financial, employment and relationship problems).
  
  
• Previous traumatic experiences to which the person has not fully adjusted.
  
  
• Events which have a special meaning. For example:
• Death or serious injury of a child tends to have a particularly disturbing effect on survivors.
• Rescuers and healthcare staff who "identify" with a victim of a trauma and realise that it could have happened to them or to a loved one may also be adversely affected.