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Traumatic Stress in the Community: Identification and Intervention

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Handbook of Community Psychiatry

Abstract

Descriptions of trauma—an experience that overwhelms an individual’s ability to cope and elicits feelings of terror, helplessness, and/or out-of-control physiological arousal—have appeared in popular, historical, and medical texts for centuries. The relevance of traumatization (i.e., when “both internal and external resources are inadequate to cope with external threat”) (van der Kolk 1989, p. 393) to normal and impaired functioning is described in great detail in social, neuropsychological, and political texts. This chapter summarizes the current understanding of traumatic stress (i.e., the physical and emotional responses to events that threaten the physical or psychic integrity of an individual) and traumatic stress disorders and the evidence for effective intervention. Prevention of trauma, the ultimate effective community intervention, is best described in other texts.

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References

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • Beals, J., Manson, S. M., Shore, J. H., Friedman, M., Ashcraft, M., Fairbank, J. A., et al. (2002). The prevalence of posttraumatic stress disorder among American Indian Vietnam veterans: Disparities and context. Journal of Traumatic Stress, 15, 89–97.

    Article  PubMed  Google Scholar 

  • Benedek, D. M., Friedman, M. J., Zatzick, D., & Ursano, R. J. (2009). Guideline watch (March 2009): Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Arlington, VA: American Psychiatric Association.

    Google Scholar 

  • Berger, W., Mendlowicz, M., Marques-Portella, C., Kinrys, G., Fontenelle, L., Marmar, C., & Figueira, I. (2009). Pharmacologic alternatives to antidepressants in posttraumatic stress disorder: A systematic review. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 33, 169–180.

    Article  Google Scholar 

  • Bisson, J. I., & Cohen, J. A. (2006). Disseminating early interventions following trauma. Journal of Traumatic Stress, 19(5), 583–595.

    Article  PubMed  Google Scholar 

  • Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. The American Journal of Psychiatry, 162(2), 214–227.

    Article  PubMed  Google Scholar 

  • Breslau, N., & Kessler, R. C. (2001). The stressor criterion in DSM-IV posttraumatic stress disorder: An empirical investigation. Biological Psychiatry, 50, 699–704.

    Article  PubMed  Google Scholar 

  • Briere, J. (2006). Assessing trauma and posttraumatic outcomes. In J. Briere & C. Scott (Eds.), Principles of trauma therapy: A guide to symptoms, evaluation, and treatment (pp. 37–63). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Cahill, S. P., Foa, E. B., Hembree, E. A., Marshall, R. D., & Nacash, N. (2006). Dissemination of exposure therapy in the treatment of posttraumatic stress disorder. Journal of Traumatic Stress, 19(5), 597–610.

    Article  PubMed  Google Scholar 

  • Cloitre, M., Stovall-McClough, K. C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C. L., Gan, W., & Petkova, E. (2010). Treatment for PTSD related to childhood abuse: A randomized controlled trial. The American Journal of Psychiatry, 167(8), 915–924.

    Article  PubMed  Google Scholar 

  • Davidson, J., Baldwin, D., Stein, D., Kuper, E., Benattia, I., Ahmed, S., Pedersen, R., & Musgnung, J. (2006). Treatment of posttraumatic stress disorder with venlafaxine extended release: A 6-month randomized controlled trial. Archives of General Psychiatry, 63, 1158–1165.

    Article  PubMed  Google Scholar 

  • Davis, M., Barad, M., Otto, M., & Southwick, S. (2006). Combining pharmacotherapy with cognitive behavioral therapy: Traditional and new approaches. Journal of Traumatic Stress, 19(5), 571–581.

    Google Scholar 

  • Foa, E. (2009). Effective treatments for PTSD (2nd ed.). New York, NY: Guilford.

    Google Scholar 

  • Freuch, B. C., Grubaugh, A. L., Cusack, K. J., & Elhai, J. D. (2009). Disseminating evidence-based practices for adults with PTSD and severe mental illness in public sector mental health agencies. Behavior Modification, 33(1), 66–81.

    Google Scholar 

  • Haglund, M. E. M., Nestadt, P. S., Cooper, N. S., Southwick, S. M., & Charney, D. S. (2007). Psychobiological mechanisms of resilience: Relevance to prevention and treatment of stress-related psychopathology. Development and Psychopathology, 19, 889–920.

    Article  PubMed  Google Scholar 

  • Hodas, G. R. (2006). Responding to childhood trauma: The promise and practice of trauma. Retrieved February 18, 2011, from http://www.nasmhpd.org/general_files/publications/ntac_pubs/Responding%20to%20Childhood%20Trauma%20-%20Hodas.pdf.

  • Hopper, E. K., Bassuk, E. L., & Olivet, J. (2010). Shelter from the storm: Trauma-informed care in homelessness services settings. The Open Health Services and Policy Journal, 3, 80–100.

    Article  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62, 617–627.

    Article  PubMed  Google Scholar 

  • Lester, K., Resick, P., Young-Xu, Y., & Artz, C. (2010). Impact of race on early treatment termination and outcomes in posttraumatic stress disorder treatment. Journal of Consulting and Clinical Psychology, 78(4), 480–489.

    Article  PubMed  Google Scholar 

  • Marsenich, L. (2010). Trauma informed care. Retrieved February 18, 2010, from http://www.cacfs.org/materials/Alliance%20-%20trauma%20informed%20care.pdf.

  • Mueser, K. T., Rosenberg, S. D., Goodman, L. A., & Trumbetta, S. L. (2002). Trauma, PTSD, and the course of severe mental illness: An interactive model. Schizophrenia Research, 53, 123–143.

    Article  PubMed  Google Scholar 

  • Mueser, K. T., Rosenberg, S. D., Xie, H., Jankowski, M. K., Bolton, E. E., Lu, W., Hamblen, J. L., Rosenberg, H. J., McHugo, G. J., & Wolf, R. (2008). A randomized controlled trial of cognitive-behavioral treatment for posttraumatic stress disorder in severe mental illness. Journal of Consulting and Clinical Psychology, 76(2), 259–271.

    Article  PubMed  Google Scholar 

  • National Institute for Clinical Excellence. (2005). Post-traumatic stress disorder (PTSD): The management of PTSD in adults and children in primary and secondary care. Clinical guideline 26. London, UK: Author.

    Google Scholar 

  • National Institute of Mental Health. (2002). Mental health and mass violence: Evidence-based early psychological interventions for victims/survivors of mass violence. A workshop to reach consensus on best practices (NIH Publication No. 02-5138). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Osofsky, J. D., Putnam, F. W., & Lederman, C. S. (2008). How to maintain emotional health when working with trauma. Juvenile and Family Court Journal, 59(4), 91–102.

    Article  Google Scholar 

  • Peacock, C., Hardy, K., & Panzer, P. (2011). Developing training with a racial lens. New York, NY: JBFCS.

    Google Scholar 

  • Pearlman, L. A. (1995). Self-care for trauma therapists: Ameliorating vicarious traumatization. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (pp. 51–64). Baltimore, MD: The Sidran Press.

    Google Scholar 

  • Pole, N., Best, S. R., Metzler, T., & Marmar, C. R. (2005). Why are Hispanics at greater risk for PTSD? Cultural Diversity & Ethnic Minority Psychology, 11, 144–161.

    Article  Google Scholar 

  • Pole, N., Gone, J. P., & Kulkarni, M. (2008). Posttraumatic stress disorder among ethnoracial minorities in the United States. Clinical Psychology: Science and Practice, 15(1), 35–61.

    Article  Google Scholar 

  • Rivard, J. C., Bloom, S. L., Abramovitz, R., Pasquale, L. E., Duncan, M., McCorkle, D., & Gelman, A. (2003). Assessing the implementation and effects of a trauma-focused intervention for youths in residential treatment. Psychiatric Quarterly, 74(2), 137–154.

    Article  PubMed  Google Scholar 

  • Robinson, R. (2008). Reflections on the debriefing debate. International Journal of Emergency Mental Health, 10(4), 253–260.

    PubMed  Google Scholar 

  • Saxe, G. N., Ellis, H. B., & Kaplow, J. B. (2007). Collaborative treatment of traumatized children and teens: The trauma-systems therapy approach. New York, NY: Guilford.

    Google Scholar 

  • Sullivan, G., & Neria, Y. (2009). Pharmacotherapy of PTSD: Current status and controversies. Psychiatric Annals, 39(6), 342–347. Retrieved June 6, 2009, from http://PsychiatricAnnalsOnline.com.

    Google Scholar 

  • TF-CBT Web. (2005). Trauma-focused cognitive behavioral therapy. Retrieved November 8, 2010, from http://tfcbt.musc.edu/.

  • Triffelman, E. G., & Pole, N. (2010). Future directions in studies of trauma among ethnoracial and sexual minority samples: Commentary. Journal of Consulting and Clinical Psychology, 78(4), 490–497.

    Article  Google Scholar 

  • U.S. Department of Veterans Affairs National Center for PTSD. (2010). Clinician’s Guide to Medications for PTSD. Retrieved October 2010, from http://www.ptsd.va.gov.

  • van der Hart, O., Steele, K., & Ford, J. D. (2001, Fall). Introducing issues in the treatment of complex PTSD. Traumatic Stress Points. Retrieved August 26, 2010, from http://www.istss.org/TraumaticStressPoints/2447.htm.

  • van der Kolk, B. A. (1989). The compulsion to repeat the trauma: Reenactment, revictimization, masochism. In B. A. van der Kolk (Ed.), Psychiatric clinics of North America (Treatment of victims of sexual abuse, Vol. 12, pp. 389–411). Philadelphia, PA: W.B. Saunders.

    Google Scholar 

  • van der Kolk, B. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401–408.

    Google Scholar 

  • Yehuda, R., & LeDoux, J. (2007). Response variation following trauma: A translational neuroscience approach to understanding PTSD. Neuron, 56, 19–32.

    Article  PubMed  Google Scholar 

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Acknowledgments

Special thanks to Greg Sullivan, MD and the JBFCS MKSEI team for contributions and edits.

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Correspondence to Paula G. Panzer MD .

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Panzer, P.G., Snipes, E., Peacock, C. (2012). Traumatic Stress in the Community: Identification and Intervention. In: McQuistion, H., Sowers, W., Ranz, J., Feldman, J. (eds) Handbook of Community Psychiatry. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3149-7_12

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