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  • Print publication year: 2007
  • Online publication date: August 2009

7 - Acute stress disorder and post-traumatic stress disorder in the disaster environment

from Part III - Clinical care and interventions


The chapter highlights the idea that many individuals exposed to significant trauma do not develop acute stress disorder (ASD) or post-traumatic stress disorder (PTSD) and describes subgroups that may be at greater risk for these conditions in the aftermath of disaster. It reviews neurobiological mechanisms in normal and pathological traumatic stress responses. Traumatic experience results in both immediate and long-term endocrine changes that affect metabolism and neurophysiology. Some evidence exists to support the effectiveness of psychotherapeutic approaches immediately after trauma in preventing the development of ASD or PTSD. Cognitive-behavioral therapy (CBT) attempts to correct cognitive distortions and reduce the frequency and symptomatology associated with traumatic memories. Selective serotonin reuptake inhibitors (SSRIs) are considered the first-line medication treatment for PTSD. The clinical interview remains the gold standard for the assessment of ASD or PTSD for several reasons. Future research should help to identify individual and group-specific risk factors or vulnerabilities.
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