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- Title
The nature and longitudinal course of psychological trauma.
- Authors
McFarlane, Alexander C.
- Abstract
In comprehending the nature of posttraurnatic reactions, time is a critical dimension in understanding the nature and severity of reactions. The relationship between the acute reaction to the traumatic event and posttraumatic stress disorder (PTSD) is an issue that is frequently referred to, and many assumptions are presumed. In particular, it is often presumed that those who develop PTSD behave in maladaptive ways at the time of the trauma. Increasingly it appears that there are relatively few differences in the immediate proximity of traumatic events between those who go on to develop PTSD, as opposed to those who do not develop any disorder or develop conditions such as posttraumatic depression. It appears that the disorder emerges in the days and weeks that follow the event, suggesting some abnormality of dampening of reactivity. While PTSD is a valuable construct in describing the long-term outcomes of trauma, it is important to recognize that there are a range of other psychiatric disorders such as depression, substance abuse and anxiety which can emerge in the aftermath of these experiences. The longer term follow-up of traumatized populations also increasingly demonstrates the impact on their health and health-seeking behaviors. The long- term course of PTSD can best be understood by considering the interaction between a range of biological, psychological and social variables that influence the individual's propensity and predisposition. The nature of the biological stress response at the time of the trauma may be a critical factor that influences the long-term outcome. As well, the patterns of substance abuse can also modify the longitudinal phenomenology of this disorder. The emergence of findings from longitudinal studies is increasingly indicating that the nature of PTSD at different points in its life history may need to be distinguished. It is possible that treatment interventions that are effective at one point may not be so in the more chronic forms. The progressive psychobiological changes in this condition require greater clarification.
- Subjects
PSYCHOLOGICAL stress; POST-traumatic stress disorder; EMOTIONAL trauma; MENTAL depression; PERINATAL mood &; anxiety disorders; PSYCHOLOGICAL distress; PSYCHIATRY
- Publication
Psychiatry & Clinical Neurosciences, 1998, Vol 52, pS49
- ISSN
1323-1316
- Publication type
Article