Neurobiology of disaster exposure: fear, anxiety, trauma, and resilience

Rebecca P. Smith; Craig L. Katz; Dennis S. Charney; Steven M. Southwick

doi:10.1017/CBO9780511544415.006

5 - Neurobiology of disaster exposure: fear, anxiety, trauma, and resilience

from Part II - Foundations of disaster psychiatry

Published online by Cambridge University Press: 09 August 2009

Rebecca P. Smith ,

Craig L. Katz ,

Dennis S. Charney and

Edited by

Lars Weisaeth and

Rebecca P. Smith: Affiliation:
Assistant Clinical Professor World Trade Center Worker and Volunteer Mental Health Screening, Monitoring and Interventions Programs
Craig L. Katz: Affiliation:
Assistant Clinical Professor Psychiatry Mount Sinai School of Medicine
Dennis S. Charney: Affiliation:
Professor Psychiatry Mount Sinai School of Medicine
Steven M. Southwick: Affiliation:
Professor Section of Child Study Center Yale University
Robert J. Ursano: Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Carol S. Fullerton: Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Lars Weisaeth: Affiliation:
Universitetet i Oslo
Beverley Raphael: Affiliation:
University of Western Sydney

Book contents

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Summary

Introduction

To date, clinical and research approaches to disaster mental health have focused primarily on the psychological experience of disaster survivors, and the development and effectiveness of psychological treatments. While these studies have contributed greatly to our understanding of the human response to disaster, it has become clear in recent years that, in addition to psychological approaches, neurobiological approaches to disaster-related psychopathology and resilience are also potentially informative.

Multiple neurobiological systems are involved in the human response to threat. Simultaneous activation of various brain regions and neurotransmitter systems allows the organism to assess and appropriately respond to potential dangers. This dynamic process contributes to the development of anxiety, fear, and the “fight or flight” response that allows the organism to protect itself by either fleeing from, or actively confronting, danger. Fear triggers the familiar “fight or flight” response, characterized by acute increased heart rate, breathing, and muscle tension, which facilitate escape from danger or defense against danger (e.g., predator). Based on a complex process of recognition and appraisal of internal and external stimuli, the brain regulates the strength and duration of this coping mechanism, and generally turns it off when it is appropriate to do so. Malfunction of regulatory systems, however, can lead to excessive fear, anxiety disorders such as post-traumatic stress disorder (PTSD) and significant impairment and disability in vulnerable individuals.

Keywords

disaster HPA axis neurobiological models neurobiological resilience PTSD sympathetic nervous system pharmacological intervention neuroimaging

Type: Chapter
Information: Textbook of Disaster Psychiatry , pp. 97 - 118

DOI: https://doi.org/10.1017/CBO9780511544415.006 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

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