New insights into secondary prevention in post-traumatic stress disorder

Joseph Zohar, Alzbeta Juven-Wetzler, Rachel Sonnino, Shlomit Cwikel-Hamzany, Evgenya Balaban, Hagit Cohen

Research output: Contribution to journalArticlepeer-review

65 Scopus citations

Abstract

Post-traumatic stress disorder (PTSD) is unique amongst psychiatric disorders in two ways. Firstly, there is usually a very clear point of onset- the traumatic event The second unique feature of PTSD is that it is characterized by a failure of the normal response to resolve. Given these two characteristics, PTSD appears a good candidate for secondary prevention, ie, interventions immediately after the trauma. Evidence available starting from current concepts and contemporary research of potential secondary prevention interventions are presented. Common practices in the aftermath of trauma such as debriefing and benzodiazepines need to be carefully considered, taking into account their potential harm to the spontaneous recovery process, and the trajectory of PTSD, and not only judging them according to their immediate (comforting) effects. A discussion of the balance required between aiding recovery but not interfering with the potent natural resolution of symptoms (that is expected in most cases), along with potential avenues of future research, are presented. Results of a small pilot study with a single intervention of hydrocortisone immediately after trauma appear to be promising, and clearly indicate the need for further studies.

Original languageEnglish
Pages (from-to)301-309
Number of pages9
JournalDialogues in Clinical Neuroscience
Volume13
Issue number3
StatePublished - 1 Dec 2011

Keywords

  • Animal model
  • Cortisol
  • HPA axis
  • Post-traumatic stress disorder
  • Prevention
  • Spontaneous recovery

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