Reactions to stressful experiences

Author(s):  
Paul Harrison ◽  
Philip Cowen ◽  
Tom Burns ◽  
Mina Fazel

‘Reactions to stressful experiences’ covers emotional and physiological elements of the response to stress and the way in which maladaptive coping patterns and inappropriate defence mechanisms can lead to clinical disorders. Stress reactions are often short-lived and respond to support from friends and family. However, particularly severe stresses can lead to the condition of post-traumatic stress disorder (PTSD), an important source of morbidity and disability, whose clinical features, psychology, neurobiology, and treatment are described in detail. The chapter also covers adjustment to threatening and traumatic life events, such as childhood abuse, sexual assault in women, the refugee experience, serious physical illness, and bereavement. These events can produce various kinds of adverse psychological consequences over the lifespan, and the chapter shows how these psychiatric sequelae can be recognized, theoretically understood, and best managed according to current evidence-based practice.

Author(s):  
Philip Cowen ◽  
Paul Harrison ◽  
Tom Burns

Chapter 8 begins with a description of the various components of the response to stressful events, including coping strategies and mechanisms of defence. The classification of reactions to stressful experience is discussed next. The various syndromes are then described, including acute stress reactions, post-traumatic stress disorder, special forms of response to severe stress, and adjustment disorders. The chapter ends with an account of special forms of adjustment reaction, including adjustment to bereavement (grief) and to terminal illness, and the problems of adults who experienced sexual abuse in childhood.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041469
Author(s):  
Alida J van der Ham ◽  
Hilde P A van der Aa ◽  
Peter Verstraten ◽  
Ger H M B van Rens ◽  
Ruth M A van Nispen

ObjectiveHaving a visual impairment is known to be associated with an increased vulnerability to (potentially) traumatic events. Little is known about how people with visual impairment experience and process such events. This qualitative study aimed to provide more insight into experiences with traumatic events, consequences of traumatic events and post-traumatic stress disorder (PTSD)-related care among people with visual impairment and PTSD.MethodsEighteen persons with visual impairment and (a history of) PTSD were interviewed. Among them were 14 women and 4 men aged between 23 and 66 years. Recruitment of participants was done through health professionals from two low-vision service centres and a patient association for people with eye diseases and visual impairment in The Netherlands. Interviews focused on experiences with (1) traumatic events, (2) consequences of traumatic events and (3) PTSD-related care. Thematic content analysis of interview data was performed using ATLAS.ti. The COnsolidated criteria for REporting Qualitative research (COREQ) checklist was used to check for completeness and transparency of the study. Data were collected between 2018 and 2020.ResultsThe most commonly reported traumatic events were sexual and physical abuse. Many participants experienced that their impairment had negatively affected their acceptance by others, independence and self-esteem, increasing their vulnerability for traumatic events. Additionally, having a visual impairment negatively impacted participants’ ability to respond to situations and aggravated post-traumatic stress reactions. Existing treatments seem suitable for people with visual impairment when accommodated to the impairment.ConclusionsHaving a visual impairment may affect traumatic events and post-traumatic stress reactions, particularly by contributing to low self-esteem, problems in social interactions and a lack of visual information. Insights from this study provide starting points for adapting pretraumatic and post-traumatic care to the needs of people with visual impairment.


2021 ◽  
Vol 11 (8) ◽  
pp. 44-54
Author(s):  
Julia Budzyńska ◽  
Magdalena Leśniewska ◽  
Ilona Kozioł ◽  
Joanna Milanowska

BACKGROUND: The outbreak of a coronavirus pandemic in 2019 posed a serious threat to the global population. Coronavirus Disease 2019 (COVID-19) has not only been a public health emergency, but has also affected mental health worldwide. Patients were exposed to a number of significant stressors during COVID-19 infection by which it appears that it may have had a major impact on mental health. Little is known about changes in levels of psychological affect, stress, anxiety and depression during this pandemic.AIM OF THE STUDY: The purpose of this study was to analyze the most recent available literature on the association of pandemic COVID-19 with psychiatric disorders occurring both as a result of past infection and in response to stress associated with the new situation of a global epidemic of Sars-CoV-2 virus.RESULTS: The psychological effects of the epidemic are clearly noticeable. The study identified groups particularly vulnerable to developing symptoms of anxiety, depression and post-traumatic stress disorder. Risk factors were also identified in people working in health care as having direct contact with the effects of infection with the new virus.SUMMARY AND CONCLUSIONS: Key elements of preventing psychological impact are the creation of a mental health organization. Another important task for governments is to create the conditions for economic security, as financial problems or job losses can also be the cause of mental crises.


Author(s):  
Jasim Anwar

With the ever-increasing number of natural disasters, it is important to understand the impact on the health and wellbeing of survivors, especially women. The reproductive and mental health of women contributes significantly to their overall wellbeing. The Chapter gives an overview of natural disasters with an emphasis on consequences of earthquakes of health and wellbeing of the survivors. It includes a critical review of published studies on psychological trauma and reproductive health following earthquake disasters. Among the psychological consequences of earthquakes, this chapter describes post-traumatic stress disorder, depression and anxiety. The last section of this chapter reviewed reproductive health in relation to the mental health consequences following natural disasters.


2020 ◽  
pp. 1-8
Author(s):  
Amy Hardy ◽  
Ciaran O'Driscoll ◽  
Craig Steel ◽  
Mark van der Gaag ◽  
David van den Berg

Abstract Background Understanding the interplay between trauma-related psychological mechanisms and psychotic symptoms may improve the effectiveness of interventions for post-traumatic stress reactions in psychosis. Network theory assumes that mental health problems persist not because of a common latent variable, but from dynamic feedback loops between symptoms, thereby addressing the heterogeneous and overlapping nature of traumagenic and psychotic diagnoses. This is a proof-of-concept study examining interactions between post-traumatic stress symptoms, which were hypothesized to reflect trauma-related psychological mechanisms, and auditory hallucinations and delusions. Method Baseline data from two randomised controlled trials (N = 216) of trauma-focused therapy in people with post-traumatic stress symptoms (87.5% met diagnostic criteria for PTSD) and psychotic disorder were analysed. Reexperiencing, hyperarousal, avoidance, trauma-related beliefs, auditory hallucinations and delusional beliefs were used to estimate a Gaussian graphical model along with expected node influence and predictability (proportion of explained variance). Results Trauma-related beliefs had the largest direct influence on the network and, together with hypervigilance, were implicated in the shortest paths from flashbacks to delusions and auditory hallucinations. Conclusions These findings are in contrast to previous research suggesting a central role for re-experiencing, emotional numbing and interpersonal avoidance in psychosis. Trauma-related beliefs were the psychological mechanism most associated with psychotic symptoms, although not all relevant mechanisms were measured. This work demonstrates that investigating multiple putative mediators may clarify which processes are most relevant to trauma-related psychosis. Further research should use network modelling to investigate how the spectrum of traumatic stress reactions play a role in psychotic symptoms.


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