Early intervention for post‐traumatic stress disorder

Abstract

Aims: The potentially debilitating effect of posttraumatic stress disorder (PTSD) has created much interest in early intervention strategies that can reduce PTSD. This review critiques the evidence for psychological debriefing approaches and alternate early intervention strategies. Methods:The review critiques the randomized controlled trials of psychological debriefing, and early provision of cognitive behavior therapy. The latter approach involves therapy attention on acutely traumatized individuals who are high risk for PTSD development, and particularly in people with acute stress disorder (ASD).Results: Psychological debriefing does not prevent PTSD. Cognitive behaviour therapy strategies have proven efficacy in reducing subsequent PTSD in ASD populations. Conclusions:Despite the promising evidence for early provision of CBT, many people do not benefit from CBT. This review concludes with consideration of major challenges facing early intervention approaches in the context of terrorist attacks and mass disasters.

Prevention of Trauma and Stressor-Related Disorders: A Review

“…In addition to these approaches, a number of other interventions have also been studied. The evidence for several psychosocial approaches to PTSD prevention, including single session and CBT-based interventions, has been examined in depth in several reviews (Agorastos et al, 2011;Bryant, 2007;Forneris et al, 2013;Kearns et al, 2012;Rose et al, 2002). For this reason, we will summarize evidence for each approach but will not describe each study separately.…”

Pszichológiai intervenciók traumatikus események után a poszttraumás stressz zavar megelőzésére. Szisztematikus irodalmi áttekintés

“…A PTSD azonnali (traumát követő 72 órában) és korai (traumát követő 4 hétben), prevenciós jelleggel végzett hatékony pszichológiai intervenciói e kórkép személyre és társadalomra gyakorolt negatív hatásait csökkenthetik [21]. A korai intervenciók hatékonyságára vonatkozó közlemények és összefoglalók ellentmondó következtetéssel zárulnak [22,23,24,25]. Tanulmányunk célja a legújabb eredmények összefoglalása, a PTSD megelőzését célzó azonnali és korai, pszichológiai intervenciók hatékonyságá-nak értékelésére felnőttek körében.…”

An investigation of the rescue personality in firefighter recruits.

“…Symptoms o f PTSD include reliving the event, having trouble remembering important details about the event, avoiding reminders o f the event, loss o f interest in previously enjoyable activities, feelings o f indifference, hyperarousal, and irritability (APA, 2000;Bryant, 2007;Chiu et al, 2011;Haslam & Mallon, 2003). These symptoms usually begin within three months o f the traumatic exposure, with approximately half o f cases recovering in the following three months.…”

“…Although CISD programs have been generally perceived as being "helpful" among emergency services personnel (Devilly et al, 2006), it has been suggested that those who value CISD the most are the ones who also need it the least (Raphael & Wooding, 2004). Furthermore, some studies involving firefighters and other emergency services personnel have even gone as far as to conclude that CISD is associated with an even greater risk o f PTSD when compared to those who do not participate in CISD (Bryant, 2007;Irving & Long, 2001;Kaplan, Iancu, & Bodner, 2001;Rose, Bisson, Churchill, & Wessely, 2002;Szumilas, Wei, & Kutcher, 2010). One randomized control trial (RCT) o f bum victims who either did or did not participate in CISD after their incident revealed that 26% o f CISD participants went on to develop PTSD as compared to 9% o f the control group (Bisson, Jenkins, Alexander, & Bannister, 1997).…”

“…In regards to therapeutic interventions for PTSD, reliance on CISD should be used with caution as CISD may inadvertently cause participants to relive aspects of the traumatic event that may not have directly experienced themselves (Devilly et al, 2006;van Emmerik et al, 2002). In cases where this does occur, CISD may actually increase the risk o f developing PTSD in an already high risk population (Bryant, 2007;Irving & Long, 2001;Kaplan et al, 2001;Rose et al, 2002;Szumilas et al, 2010). In order to avoid the possible detrimental effects o f using CISD alone, CISD should be incorporated into a wider CISM program along with individual counselling when traumatic events do occur (van Emmerik et al, 2002) and proactive teaching o f coping skills.…”