Susceptibility, Resilience, and Trajectories

Author(s):  
Jack Tsai ◽  
Natalie Jones ◽  
Robert H. Pietrzak ◽  
Ilan Harpaz-Rotem ◽  
Steven M. Southwick

Nearly everyone experiences a highly stressful or traumatic event during their lifetime. However, individual responses to such events vary widely from person to person. Some people respond with symptoms of anxiety, depression, acute stress, or posttraumatic stress disorder, yet others experience minimal or no psychiatric symptoms after trauma. What makes one person more susceptible and another more resilient to the negative effects of trauma? What are the different adaptive trajectories of trauma survivors and what determines their trajectory? These are some of the questions that are examined in this chapter, which focuses on what is currently known about resilience to stress. The chapter is divided into five sections: definition, prevalence, and measurement of resilience; longitudinal studies on trajectories after trauma exposures; research on factors that are predictive of resilience and different trajectories; interventions that have been developed to increase resilience; and discussion about future directions for research on resilience.

CNS Spectrums ◽  
2006 ◽  
Vol 11 (8) ◽  
pp. 585-586
Author(s):  
Ehud Klein

Posttraumatic stress disorder (PTSD) is a well-defined clinical syndrome that develops in individuals who have witnessed or been exposed to an event that involves a direct threat to life or physical and/or psychological integrity.While numerous studies indicate that PTSD will develop in 15% to 25% of trauma victims, time-limited responses develop in a larger portion of victims during the first 48–72 hours (acute stress reaction) and to a lesser extent over the first 4 weeks (acute stress disorder). Many of those who suffer from acute posttraumatic symptoms eventually recover and overcome the consequences of the traumatic event. However, ∼30% to 50% of those with acute stress disorder will eventually develop PTSD. It is obvious that some individuals are vulnerable to the adverse effects of trauma while others have neurobiological and psychological resources that make them resilient to the long-term impact of traumatic exposure. The identification of risk factors and early predictors for PTSD is thus of major importance for identifying those at risk and for initiating therapeutic interventions aimed to reduce long-term morbidity and suffering.


Author(s):  
Barbara Olasov Rothbaum ◽  
Edna B. Foa ◽  
Elizabeth A. Hembree ◽  
Sheila A. M. Rauch

Not every trauma survivor needs a trauma-focused treatment like prolonged exposure (PE). Many studies have shown that natural recovery works very well for many people who experience a traumatic event. In fact, posttraumatic stress disorder (PTSD) symptoms and other trauma reactions are very common and happen for almost everyone right after a trauma, but then these symptoms and reactions decrease a lot for many people, especially over the first 3 months. This chapter helps trauma survivors determine if PE therapy is appropriate for them, and, if so, the chapter provides motivation for treatment.


Author(s):  
Andrea Feijo Mello ◽  
Mary Sau Ling Yeh

After a traumatic event most people experience a period of distress, and usually a resilient response is observed and no intervention is necessary. However, one-fifth of subjects can develop an Acute Stress Disorder (ASD) within the first month after exposure, and if the reaction lasts for more than a month, a diagnosis of Posttraumatic Stress Disorder (PTSD) is usually made. Despite its prevalence, PTSD is likely to be under-recognized and under-treated, mostly in primary care settings. Primary care physicians can play an important role in identifying people with symptoms of ASD and PTSD, early detection and collaborative care treatment may improve prognosis.


2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Brandon A. Kohrt ◽  
Erica Duncan

Hemicrania continua is a headache characterized by chronic unremitting unilateral pain associated with ipsilateral autonomic findings. This type of headache responds to high-flow oxygen and indomethacin. This case report describes a male veteran with posttraumatic stress disorder (PTSD) and major depressive disorder who suffers from comorbid hemicrania continua. The psychiatric symptoms were recalcitrant to psychopharmacological intervention. However, when the patient's hemicrania continua was treated appropriately, the patient's psychiatric symptoms also abated. This case demonstrates the need to address physical comorbidities that may exacerbate psychiatric disorders, such as PTSD.


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