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• Research on PTSD and Other Post-Traumatic Reactions: European Literature (Part II)

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  "This is the second of a two-part series by Drs. Weisæth and Eitinger on the European PTSD [Post-Traumatic Stress Disorder] literature. Our previous issue focused on Norwegian publications, and this issue concludes with a review of publications from other European countries. PTSD is a diagnosis that spans national and cultural boundaries, even though it is strictly defined as such only in the diagnostic manual of the American Psychiatric Association. Change is underway, however, to promote the systematic global use of the term. If the 1990 draft of the proposed ICD-10 (the International Classification of Diseases) is accepted, a diagnosis of post-traumatic stress disorder will be used internationally. In addition, the ICD-10 proposes a diagnosis of 'acute stress reaction.' This must have an immediate onset, defined as developing within one hour of exposure to the exceptional mental or physical stressor. Some of our own prospective studies starting in the immediate aftermath have found a high predictive validity of an acute diagnosis. This lends support to such a diagnostic proposal, which could also eliminate the problem that the DSMIII- R diagnosis of PTSD applies only after one month. In some other studies, for example, one on rape victims (this issue), the acute response was not predictive of PTSD; a combined formula of risk factors was needed for prediction. In addition, the ICD-10 proposes a diagnosis of 'enduring personality change after catastrophic experiences' when the specific personality changes have been present for at least three years. The changes meeting the criteria will often have been preceded by a long-lasting post-traumatic stress disorder. There are extensive ongoing consultations between the ICD10 and DSM-IV committees. Summing up, it will be an exciting challenge for the researcher in traumatic stress over the next few years to determine diagnostic categories that match clinical reality."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  Weisaeth, Lars; Eitinger, Leo, 1912-1996

  1991
• Animal Models for the Neurobiology of Trauma

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  This article on Post-Traumatic Stress Disorder (PTSD) discusses the study of animal responses to extreme stress or trauma as a means to better understand and treat PTSD in humans. From the article: "The animal model of inescapable stress mimics the exposure to extreme stress seen in patients with PTSD. Animals exposed to inescapable stress develop specific behavioral changes including deficits of memory, learned helplessness, and conditioned fear responses to stressors, which are associated with long-term changes in multiple neurobiological systems. This model has proven useful in the study of the neurobiological and behavioral consequences of trauma. In this issue we review animal models and preclinical research on the neurobiology of trauma. [...] Clinicians will notice parallels between the behavioral and biological sequelae of inescapable stress and the phenomenology of PTSD symptoms in their patients. The animal model of inescapable stress parallels the experience of being pinned down in combat or being the victim of repeated assaults. Inescapable stress produces a variety of behaviors in animals including abnormal alarm states, aggression, sensitivity to stress, altered sleep patterns, deficits in learning and memory, and withdrawal. These behaviors resemble those seen in patients with PTSD. As reviewed above, there are also a variety of neurobiological alterations produced by exposure to inescapable stress. This may provide a framework in which to conduct investigations designed to determine if similar changes occur in PTSD. For instance, evidence from animal findings of alterations in noradrenergic brain systems is consistent with emerging findings of abnormalities in noradrenergic systems in patients with PTSD as evidenced by abnormal responses to the alpha-2 noradrenergic receptor antagonist yohimbine. The identification of specific neurobiological abnormalities may lead to the development of new psychopharmacological and psychotherapeutic treatments based on the pathophysiology of PTSD."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  Bremner, J. Douglas, 1961-; Southwick, Stephen M.; Charney, Dennis S.

  1991
• Trauma of Sexual Victimization: Feminist Contributions to Theory, Research, and Practice

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  This article on Post-Traumatic Stress Disorder (PTSD) discusses the feminine perspective and research contributions on sexual trauma among women and girls. From the article: "Twenty years ago, rape was thought of as a rare event, incest as a culturally universal taboo. Public and professional awareness have undergone dramatic transformation in the course of just two decades (Briere, 1992). Today, the literature is replete with research examining the scope and trauma of sexual victimization. We have chosen to focus on feminist contributions to understanding the sexual victimization of women and girls. We have abstracted our own most recent books (Herman, 1992; Koss & Harvey, 1991) and a number of works that together highlight twenty years of feminist inquiry. Readers interested in male victims are referred to a recent review by Watkins and Bentovim (1992)."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  Harvey, Mary R.; Herman, Judith Lewis, 1942-

  1992
• Mental Health Effects of Natural and Human-made Disasters

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  "All research reviewed in this issue relates to mental health studies of adult and child survivors of natural and human-made disasters. To avoid overlap with previous issues of the PTSD [Post-Traumatic Stress Disorder] Research Quarterly (Weisæth & Eitinger, Volume 2, Numbers 2 & 3) we have restricted our focus to studies conducted in the United States. We also have excluded studies that focus on emergency workers, and on victims of torture, terrorism, and other interpersonal violence, since we regard these as topics worthy of separate attention in the Quarterly. And while our abstracts are limited to studies published since 1978, we have included a few citations of classic early work in the field of disaster research. Mental health studies of disasters typically have been designed to answer three basic questions: What kinds of mental health problems, if any, result from exposure to disaster? Which groups of people are at highest risk for negative effects? And, what factors modify the impact of exposure to disaster (i.e., why are some people at particularly high risk)? In this review we include abstracts and citations of studies that address one or more of these questions."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  Solomon, Susan D.; Green, Bonnie L.

  1993
• Resources for Providers: Responding to Sudden Trauma

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  "Following disasters or terrorism, initial intervention involves reducing primary distress and offering practical assistance. The resources [here] will help first responders and mental health providers learn skills in psychological first aid and appropriate response to such events."

  National Center for Post-Traumatic Stress Disorder (U.S.)
• Resources for Survivors and the Public Following Sudden Trauma

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  "Sudden traumatic events of disaster can lead to injury, death, and psychological distress. Events in the media can also trigger reminders to past events. This page links to information to help survivors and loves ones deal with stresses that can come from sudden trauma."

  National Center for Post-Traumatic Stress Disorder (U.S.)
• Disasters and Domestic Violence: Prevalence and Impact of Domestic Violence in the Wake of Disasters

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  This document is a brief literature review that looks at the current research on "whether domestic violence increases in prevalence after disasters" and if domestic violence influences women's post-disaster recovery."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  Norris, Fran H.

  2007-01-01
• For Providers and Community Leaders: Helping People Manage Stress Associated with the COVID-19 Virus Outbreak

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  From the Document: "When the public learns of an outbreak of an infectious disease such as COVID-19 [coronavirus disease], they may experience anxiety and show signs of stress, even if the objective risk of getting sick is very low. Concerns about transmission from person to person may affect accessibility of social supports and reduce community cohesion. Although public health authorities are working to contain the spread of the virus, disease outbreaks are unpredictable. If more cases occur, members of the public may well become increasingly concerned and some may begin to panic. This stress is normal and may be more pronounced in people with loved ones in parts of the world hardest hit by the outbreak. Healthcare providers, community and religious leaders, and government officials all have a role to play in helping people cope effectively and manage their stress in the current climate of concerns about COVID-19 transmission. They can: [1] provide the public with accurate and calming information about COVID-19 risk; [2] help the public recognize signs of stress in themselves and their loved ones; [3] teach them how to relieve anxiety reactions; and [4] provide them with resources so they can seek further help if necessary."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  2020-03
• Managing Healthcare Workers' Stress Associated with the COVID-19 Virus Outbreak

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  From the Document: "The wellbeing and emotional resilience of healthcare workers are key components of maintaining essential healthcare services during the COVID-19 virus (coronavirus) outbreak. Therefore, it will be crucial to anticipate the stresses associated with this work and put in place supports for healthcare workers. Monitoring and assessment of mental health and wellbeing of healthcare personnel will be important, along with efforts to ensure their successful reintegration with work colleagues, should they themselves become infected. Both institutional supports and self-care strategies are important."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  2020-03
• Managing Grief after Disaster: A National Center for PTSD Fact Sheet

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  "The recent terrorist disasters left many people suddenly bereaved of spouses, children, parents, close friends, and coworkers. In the immediate aftermath, some have been numb or unable to accept the loss. Many have felt shocked, lost, anxious, depressed, and physically unwell as a result of this loss. For many, the pain has been intense and unrelenting. In the acute aftermath of the violent death of a loved one, a sense of disbelief or intense, uncontrollable emotionality is very frequent. Distressing physical symptoms are also common (Lindeman, 1944; Stroebe & Stroebe, 1993). These emotional and bodily reactions may be very strong and can themselves be traumatizing, especially if they are unfamiliar and unexpected. Such a secondary reaction can further amplify the pain caused by the loss and can be mitigated by information about grief and stress reactions. It is important to realize that intense and unfamiliar emotionality is entirely normal and does not necessarily have implications for long-term emotional stability or health. The fact that a popular Internet book site lists 2,776 titles on the topic attests to the fact that grief is both common and difficult. In ordinary, peaceful times millions of people die every year, each leaving friends and family bereaved. Many experience numbness or intense pain in the immediate aftermath. For most, this initial reaction subsides with time, and the bereaved person finds a way to again engage fully in life. However, studies show bereaved individuals, in general, are at risk for longer term mental and physical health problems. It is a good idea to provide ongoing support, monitor the outcome of grief, and know that professional intervention can be helpful. Given the universality of bereavement, there has been relatively little research to characterize its course, develop a nosology for bereavement problems, identify risk factors, or guide treatment. The information provided below draws upon what has been done and upon ongoing work."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  Shear, M. Katherine

  2005
• Moral Injury in Healthcare Workers on the Frontlines of the Coronavirus (COVID-19) Outbreak

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  From the Document: "Moral injury (sometimes referred to as 'moral distress') can occur when someone engages in, fails to prevent, or witnesses acts that conflict with their values or beliefs. Most healthcare workers typically do not experience significant distress from difficult situations at work because of their training and preparation, healthcare cultural norms, messages and behavior of peers and leaders, and acceptance by families and the culture at large. However, in unprecedented contexts, such as a pandemic, some people may have difficulty with unfamiliar and potentially distressing work experiences."

  National Center for Post-Traumatic Stress Disorder (U.S.)
• Coronavirus (COVID-19): Resources for Managing Stress

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  From the Webpage: "The coronavirus [disease 2019] (COVID-19) pandemic can take an emotional as well as a physical toll. There are strategies that can help with the stress, grief, and anxiety that many people are feeling. This section links to information and resources to support self-care, the work of providers, and community efforts." There are also resources available specifically for Health Care Workers and Responders and Employers and Community Leaders.

  National Center for Post-Traumatic Stress Disorder (U.S.)
• Research on Trauma and PTSD in the Aftermath of 9/11

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  This article on Post-Traumatic Stress Disorder (PTSD) presents a review of trauma research related to the terrorist attacks of September 11, 2001. The article follows a timeline of research published on 9/11-related PTSD beginning with a report published within days of the event. From the article: "The September 11, 2001 terrorist attacks on the World Trade Center (WTC) in New York City and upon the Pentagon in Washington, DC were unprecedented in scope in the United States. Approximately 2,800 people were killed in the attacks, 16 times more people than died in the Oklahoma City bombing, previously the largest terrorist attack on US soil. The scope and nature of the attacks suggested that there would be substantial mental health problems in New York City after the attacks and that these problems would extend beyond the direct victims of the attacks. [...] Several epidemiological studies were conducted in the aftermath of the September 11th attacks that made use of standardized assessment measures that allowed for good comparability across studies and that included design variations that allowed for focus on different segments of the U.S. and New York area populations primarily. These studies provided fairly consistent results, identifying elevated prevalence of PTSD and consistent predictors associated with PTSD in the initial few months post-event. Future research should also incorporate more sophisticated assessment of a range of coping responses such as those assessed by Silver et al. (2002) and Schuster et al. (2001). Results of the repeated cross-sectional studies of the population in New York indicate the importance of attending to additional mental health and behavioral outcomes such as substance use that may persist over longer periods following events like the attacks that occurred on September 11th. The data also point to the resilience of those in this population in terms of symptoms of PTSD over time."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  Galea, Sandro; Kilpatrick, Dean G.; Resnick, Heidi S., 1957-

  2004
• Crime-Related PTSD: Emphasis on Adult General Population Samples

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  This article on Post-Traumatic Stress Disorder (PTSD) provides an overview of crime-related trauma incidents. From the article: "This article highlights general population studies of crime-related PTSD that provide descriptive characteristics of crime events and information relevant to the study of PTSD etiology. Following a brief overview of critical issues in research on crime and its effects, the article is divided into two major areas: Prevalence, descriptive characteristics, and risk factors for exposure to crime events; and Prevalence, and risk factors for PTSD. Given the critical role of event characteristics in the etiology of PTSD based on the combat trauma literature, it is important to recognize the need to study the detailed characteristics of different types of crime in-depth. Information about PTSD etiology can be gained from and/ or cross-validated using new populations other than combat veterans. The study of crime-related trauma permits examination of varied trauma and individual characteristics. Furthermore, crime is much more than an academic issue. Unfortunately, crime is an ongoing threat, both for individuals previously victimized who may continue to live in fear as well as for those who may falsely believe that they are invulnerable to crime. Thus, study of crime victims also allows us to look at individuals who have recently been exposed to extreme stressor events and to follow the course of PTSD and other outcomes over time."

  National Center for Post-Traumatic Stress Disorder (U.S.)

  Kilpatrick, Dean G.; Resnick, Heidi S., 1957-

  1994
• Posttraumatic Stress Disorder and Military Veterans: Training Manual for Police Officers

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  This document contains techniques and practices created to assist law enforcement officers when dealing with those affected by PTSD [posttraumatic stress disorder].

  National Center for Post-Traumatic Stress Disorder (U.S.); United States. Department of Veterans Affairs

  Walser, Robyn D.; Weaver, Christopher P.; Rosenthal, Joel . . .