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A critical review of mechanisms of adaptation to trauma: Implications for early interventions for posttraumatic stress disorder
Clinical Psychology Review ( IF 12.8 ) Pub Date : 2021-01-24 , DOI: 10.1016/j.cpr.2021.101981
Richard A Bryant 1
Affiliation  

Although many attempts have been made to limit development of posttraumatic stress disorder (PTSD) by early intervention after trauma exposure, these attempts have achieved only modest success. This review critiques the biological and cognitive strategies used for early intervention and outlines the extent to which they have prevented PTSD. The major predictors of PTSD are reviewed, with an emphasis on potential mechanisms that may underpin the transition from acute stress reaction to development of PTSD. This review highlights that there is a wide range of biological and cognitive factors that have been shown to predict PTSD. Despite this, the major attempts at early intervention have focused on strategies that attempt to augment extinction processes or alter appraisals in the acute period. The documented predictors of PTSD indicate that a broader range of potential strategies could be explored to limit PTSD. The evidence that people follow different trajectories of stress response following trauma and there is a wide array of acute predictors of PTSD indicates that a flexible and tailored approach needs to be investigated to evaluate more effective early intervention strategies.



中文翻译:

对创伤适应机制的批判性回顾:对创伤后应激障碍早期干预的影响

尽管已经进行了许多尝试通过创伤暴露后的早期干预来限制创伤后应激障碍 (PTSD) 的发展,但这些尝试仅取得了一定的成功。这篇综述批评了用于早期干预的生物学和认知策略,并概述了它们在多大程度上预防了 PTSD。回顾了 PTSD 的主要预测因素,重点是可能支持从急性应激反应向 PTSD 发展转变的潜在机制。这篇综述强调了广泛的生物学和认知因素已被证明可以预测 PTSD。尽管如此,早期干预的主要尝试集中在试图增加灭绝过程或改变急性期评估的策略上。记录在案的 PTSD 预测因子表明,可以探索更广泛的潜在策略来限制 PTSD。有证据表明,人们在创伤后会遵循不同的应激反应轨迹,并且存在多种 PTSD 的急性预测因素,这表明需要研究灵活和量身定制的方法来评估更有效的早期干预策略。

更新日期:2021-02-15
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