g., when there are deaths of several soldiers or emergency workers of a unit). Combat is a stressor that is associated with a relatively high risk of PTSD, and those interventions that can potentially diminish this risk are very important. But what is not clear in the above is how much the debriefing provided is more a form of stress management for the ?critical incidents? that are very much part of warfare, as opposed to interventions for those psycho- logically traumatized and at risk of PTSD. People in the military are exposed to stressors other than combat, and these may be traumatic (Atwater, 2009). Reports of soldiers who were involved in body recovery in the Gulf War provide important insights. This is a high-stress situation, linked to vulnerability to posttraumatic morbidity.
Asnis, et al. (2004) reported that soldiers of one group who had been debriefed were compared with another, which, for operational reasons, had not. The debriefed group was no better at longer-term follow-up: no benefits could be demonstrated for the debriefing in groups that appeared to be equivalent in experience and vulnerability to these stressors. PTSD was not prevented by this intervention. Peacekeepers also suffer experiences which may be psychologically traumatic-for instance, witnessing genocide, violence, bombing, or deaths from famine, without being able to intervene. Fairweather & Garcia, (2007) have demonstrated significant psychological morbidity in a group of peacekeepers, and cases of PTSD have also been reported in such groups. Yet these groups have had extensive briefing and debriefing in recent times. For many, however, their experiences in the developing countries where they had these peacekeeping roles were overwhelming and may well have added to their vulnerability. Soldiers, like emergency workers and others in structured crisis response services, may have their own informal "debriefing" mechanisms in socially sanctioned modalities and in more secure settings (Caplan, 1964).
III: Proposed Project Method
A proposed modality developed from Caplan's (1964) original ideas of preventive intervention following stressful life events. It has been applied as a brief intervention in association with bereavement (Seal, et al. 2007), motor vehicle accidents (Bordow & Porritt, 1979), and acute injury and illness (Martenyi, 2005). When provided in accordance with this theoretical modality, it has been shown to be effective in high-risk populations in lessening the likelihood of morbidity. Although potentially "traumatic" stressors could have been identified in each of these studies, the traumatic stress model did not inform them. While it is now known that traumatic bereavements can be associated with PTSD, that motor vehicle accidents may lead to the development of PTSD, and that life-threatening illness and injury may be associated with vulnerability to PTSD, further research in crisis intervention is needed to test this model as an acute posttraumatic intervention. Nevertheless, it is potentially so. The recontextualizing of debriefing in the crisis intervention frame- work is not really helpful, as its format, intervention, timing, and hypothesized mode of action are quite different.
IV. Proposed Project Evaluation/Data Analysis
This modality has become a subject of research in recent times, with studies showing that specific focused counseling can lessen the risk of PTSD after acute rape trauma (Asnis, et al. 2004). Trauma counseling has often been provided as a nonspecific general counseling aimed at both making better the psychological hurt and preventing the development of PTSD. Unfortunately, the marketplace demand for trauma counseling and the belief in its value have far outstripped the knowledge base of what is effective and the skills of many would-be providers. The effectiveness of focused interventions which are provided over a number of sessions in the later (2 weeks or more) acute post trauma period appears to be established (Bergfeld, 2006). These interventions are chiefly in cognitive behavioral formats which focus on the specific trauma and support reconfrontation and working through. Fairweather & Garcia, (2007) carried out a pilot study of a brief preventive intervention program for female sexual assault survivors.
The intervention built on what was known to be effective in the treatment of some chronic PTSD in such circumstances (Kennedy et al. (2007) and included exposure, relaxation training, and cognitive restructuring. The authors compared intervention and nonintervention subjects, both groups having an intervention, of four weekly 2-hour sessions which began within a month of the assault. Although
..in an optimum range, between excessive denial and excessive intrusiveness of symptoms" (366); b) "normalizing the abnormal" (let the survivor know that it is perfectly normal to react emotionally to triggers that bring the trauma to mind; there is nothing wrong with the person, and indeed, the recurring symptoms are normal and just part of the healing process); c) "decreasing avoidance" (the person should be allowed to and encouraged to
It is difficult to get an accurate record of the actual number of children that have been sexually abused. Many cases never come to light and because of differences in definitions of sexual assault, some cases are missed (658). Researchers have begun to explore the concept of Posttraumatic Stress Disorder with children and adults that were victims of sexual assault. Many times people associate particular events with particular stimuli. For
While there are approximately 5 million people suffering from the illness at any one time in America, women are twice as likely to develop PTSD as compared to men. In relation to children and teens, more than 40% has endured at least a single traumatic incident contributing the development of the disorder. However, PTSD has occurred in nearly 15% of girls as compared to the 6% of boys. Causative Factors
, 2010). This point is also made by Yehuda, Flory, Pratchett, Buxbaum, Ising and Holsboer (2010), who report that early life stress can also increase the risk of developing PTSD and there may even be a genetic component involved that predisposes some people to developing PTSD. Studies of Vietnam combat veterans have shown that the type of exposure variables that were encountered (i.e., severe personal injury, perceived life threat, longer duration,
In civilian life, such individuals will have gained a traditional ethical education whereas in a combat context, such individuals will have been instructed on the use of lethal force. According to Willis, "habit and practice help the willingness and capacity to kill on command. The new recruit or volunteer may, and likely has, the innate reservation against killing anyone. Yet day in and day out, the 'normal' person is
, 2003). The results of the study found that cocaine/PTSD were younger that alcohol/PTSD subjects (Back et al., 2003). Additionally, the researchers found that the alcohol/PTSD participants were more likely to be married and have more intimate friends than the cocaine/PTSD participants. In addition, the study found that alcohol/PTSD participants were more likely to be employed full time (Back et al., 2003). The alcohol/PTSD participants were also more likely to be
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