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4 - Acute stress disorder and early interventions after trauma

By
Richard A. Bryant
Edited by
Michael Blumenfield  and
Robert J. Ursano
Michael Blumenfield
Affiliation:
New York Medical College
Robert J. Ursano
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
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Summary

Who should we treat with early intervention?

The possibility of early intervention after trauma exposure presumes that people exposed to trauma are high risk for developing a psychiatric disorder. There are reports of high rates of emotional numbing (Feinstein, 1989; Noyes et al., 1977), reduced awareness of one's environment (Berah et al., 1984; Hillman, 1981), derealization (Cardeña and Spiegel, 1993; Freinkel et al., 1994; Noyes and Kletti, 1977; Sloan, 1988), depersonalization (Cardeña and Spiegel, 1993; Freinkel et al., 1994; Noyes et al., 1977; Sloan, 1988) dissociative amnesia (Cardeña and Spiegel, 1993; Feinstein, 1989; Madakasira and O'Brien, 1987), intrusive thoughts (Cardeña and Spiegel, 1993; Feinstein, 1989; Sloan, 1988), avoidance behaviors (Bryant and Harvey, 1996; Cardeña and Spiegel, 1993; North et al., 1989), insomnia (Cardeña and Spiegel, 1993; Feinstein, 1989; Sloan, 1988), concentration deficits (Cardeña and Spiegel, 1993; North et al., 1989), irritability (Sloan, 1988), and autonomic arousal (Feinstein, 1989; Sloan, 1988) in the weeks after trauma exposure. It is apparent that psychological distress is very commonplace in the weeks after a traumatic experience.

Although acute stress reactions are very common, there is also strong evidence that the majority of these stress responses are transient. That is, the majority of people who initially display distress naturally adapt to their experience in the following months. For example, whereas 94% of rape victims displayed post-traumatic stress disorder (PTSD) symptoms 2 weeks post-trauma, this rate dropped to 47% 11 weeks later (Rothbaum et al., 1992).

Type
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Information
Intervention and Resilience after Mass Trauma , pp. 85 - 106
Publisher: Cambridge University Press
Print publication year: 2000

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