Managing acute stress response to major trauma

Abstract

In this article, the authors review the current empiric literature on early interventions. Findings on the effects, course, help-seeking, and recovery from disasters are first reviewed, with recommendations given that are pertinent to intervention following mass casualties. In reviewing the most commonly used interventions, it is clear that evidence from well-controlled studies showing that early intervention can help prevent longer-term problems is limited. The authors discuss the approaches that have received the most attention or empiric support as early interventions following trauma, which include psychologic debriefing, cognitive-behavioral interventions, eye movement desensitization and processing (EMDR) and other neoteric approaches, and psychopharmacology. At this time, the most promising results for prevention of psychopathology have been achieved with brief four- or five-session cognitive-behavioral therapy. In contrast, randomized clinical trials on psychologic debriefing currently suggest that this approach is either ineffective at preventing psychopathology, or contributive to post-traumatic stress disorder symptoms. Research support is currently lacking for EMDR and pharmacotherapy as early interventions. A major challenge to the field is to integrate the practical experience and knowledge of professional responders with well-controlled, timely intervention research, and to effectively disseminate these findings to practitioners in the field.

Differences Between Health Workers and General Population in Risk Perception, Behaviors, and Psychological Distress Related to COVID-19 Spread in Italy

“…Such sequelae could be even more significant in health workers, showing higher levels of psychological distress both during and after a quarantine period ( Brooks et al, 2020 ). For this reason, supporting psychological intervention for healthcare workers could be crucial in the first phase of an outbreak ( Xiang et al, 2020 ), in particular considering that a timely and effective intervention could greatly reduce the later onset of posttraumatic stress disorder symptoms following a catastrophic event ( Watson et al, 2002 ).…”

Differences between health workers and general population in risk perception, behaviors, and psychological distress related to COVID-19 spread in Italy.

“…Such sequelae could be even more significant in health workers, showing higher levels of psychological distress both during and after a quarantine period (Brooks et al, 2020). For this reason, supporting psychological intervention for healthcare workers could be crucial in the first phase of an outbreak (Xiang et al, 2020), in particular considering that a timely and effective intervention could greatly reduce the later onset of post-traumatic stress disorder symptoms following a catastrophic event (Watson, Friedman, Ruzek, & Norris, 2002).…”

Bringing the War Back Home

“…Of note, the majority of mental health diagnoses occurred in nonmental health settings, most commonly primary care settings. This relatively high rate of VA enrollment and the speed with which separated OEF/OIF veterans are seen and diagnosed provide the opportunity to implement early evidencebased interventions 20 in both mental health and primary care settings to decrease chronic military servicerelated mental illness and disability.…”