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Managing acute stress response to major trauma
Patricia J Watson1, Matthew J Friedman, Josef I Ruzek
1National Center for Post-traumatic Stress Disorder, Veterans Affairs Regional Medical Center, 215 North Main Street, White River Junction, VT 05009, USA. patricia.j.watson@dartmouth.edu
Current Psychiatry Reports
|July 20, 2002
Summary
Evidence for early interventions after disasters is limited, with brief cognitive-behavioral therapy showing the most promise for preventing psychopathology. Psychological debriefing and other novel approaches lack empirical support for preventing long-term problems.
Area of Science:
- Psychology
- Trauma Studies
- Disaster Mental Health
Background:
- Early interventions are crucial for mitigating long-term psychological problems following disasters and mass casualty events.
- Existing literature on the effectiveness of these interventions is reviewed to guide practice and future research.
- Help-seeking behaviors and recovery trajectories after traumatic events are also examined.
Purpose of the Study:
- To review the empirical literature on early interventions for trauma and disaster survivors.
- To evaluate the evidence supporting various intervention approaches, including psychological debriefing, cognitive-behavioral interventions, EMDR, and psychopharmacology.
- To provide recommendations for effective interventions following mass casualty incidents.
Main Methods:
- Systematic review of existing empirical literature on early interventions post-trauma.
- Analysis of findings on the effects, course, help-seeking, and recovery from disasters.
- Evaluation of evidence from controlled studies for different intervention modalities.
Main Results:
- Evidence supporting early interventions in preventing longer-term problems is limited.
- Brief cognitive-behavioral therapy (4-5 sessions) shows the most promising results for preventing psychopathology.
- Psychological debriefing is found to be ineffective or potentially contributory to post-traumatic stress disorder symptoms.
- Research support for Eye Movement Desensitization and Reprocessing (EMDR) and pharmacotherapy as early interventions is currently lacking.
Conclusions:
- Cognitive-behavioral therapy is the most empirically supported early intervention for preventing psychopathology after trauma.
- Psychological debriefing should be approached with caution due to lack of evidence and potential negative effects.
- Integrating practitioner experience with rigorous research and effective dissemination is essential for advancing the field of early intervention.