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Secondary pharmacological interventions have shown promise at reducing the development of posttraumatic stress disorder symptoms (PTSS) in preclinical studies. The present study examined the preliminary efficacy of a 10-day low-dose (20 mg bid) course of hydrocortisone at preventing PTSS in traumatic injury victims.
Sixty-four traumatic injury patients (34% female) were randomly assigned in a double-blind protocol to receive either a 10-day course of hydrocortisone or placebo initiated within 12 hours of the trauma. One-month and 3-months posttrauma participants completed an interview to assess PTSS and self-report measures of depression and health-related quality of life.
Hydrocortisone recipients reported fewer PTSD and depression symptoms, and had greater improvements in health-related quality of life during the first 3 months posttrauma than did placebo recipients. Hydrocortisone recipients who had never received prior mental health treatment had the lowest PTSD scores.
Low-dose hydrocortisone may be a promising approach to the prevention of PTSD in acutely injured trauma patients, and may be particularly efficacious in acutely injured trauma victims without a history of significant psychopathology.
What role did President Ronald Reagan and President George H. W. Bush play in ending the Cold War? Three distinct schools of thought have arisen in response to this question. The first school maintains that the United States triumphed in the Cold War by destroying its nemesis, the USSR. These “triumphalists” focus primarily on the Reagan years and contend that the administration brought about the end of the Cold War by hastening (even causing) the collapse of the Soviet Union. In this view, the Reagan administration was keenly aware of the fragile state of the USSR. Thus, it adopted a hardline policy to push its enemy toward collapse. This policy included an unprecedented military buildup, the introduction of the Strategic Defense Initiative (SDI), and tough rhetoric. Ultimately, the Reagan administration proved victorious: the Soviets could not keep pace with the administration’s military expenditures, nor could they match US technological advances. Consequently, the Kremlin was forced to surrender. Mikhail Gorbachev, the Soviet leader, had no option other than to become more conciliatory toward Washington. The ultimate triumph came in 1991, however, when the Soviet Union ceased to exist.
A second school of thought turns this logic on its head. In this view, the Reagan administration’s hardline policies were an impediment to ending the Cold War. The president’s virulent anti-Communism, his belligerent rhetoric, SDI, and the military buildup combined to make it more difficult for Gorbachev to pursue improved relations with the West.