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REACTION TO TRAUMA: MYTHS AND REALITIES. Professor David A Alexander MA(Hons), C.Psychol, PhD, FBPS, FRSM, (Hon) FRCPsych Aberdeen Centre for Trauma Research. “Oh, give me a home, where the buffalo roam...”. “Bummer of a birthmark, Hal.". Post-traumatic Stress Disorder (PTSD).
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REACTION TO TRAUMA: MYTHS AND REALITIES Professor David A Alexander MA(Hons), C.Psychol, PhD, FBPS, FRSM, (Hon) FRCPsych Aberdeen Centre for Trauma Research
Post-traumatic Stress Disorder (PTSD) Primary features are: • experience of an abnormally stressful event • persistent re-experiencing of that event • persistent avoidance of reminders • persistent hyperarousal (hypervigilance) NB: Symptoms must have lasted for 1 month
‘The trauma epidemic’ • 10% of all deaths in UK • leading cause of death in young people • for every death two permanently disabled • high economic cost
How common are post-traumatic conditions? Best estimates (Alexander, 1997) • Burn injuries - 45% • RTAs - 18% • Industrial accidents - 18% • Major disasters - 50% • Rape - 50%
Individual reactions Cognitive Emotional Social Physical
Individual reactions Emotional Numbness Fear Depression Guilt Anger Helpless
Individual reactions Cognitive False beliefs Loss of faith Memory/ concentration Flashbacks
Individual reactions Social Avoidance Irritability Withdrawal
Individual reactions Physical Hyperarousal Sleep problems
At risk factors include... Trauma • sudden, unexpected • man made • (perceived) threat to life • extended exposure • multiple deaths/mutilations Survivor • previous trauma • psychiatric history • severity (meaning) of injury • lack of support • other stresses
Yes, but... • eviction • leukaemic daughter • redundancy • physical ill health • pending divorce
“Honeymoon” Impact Warning Enhanced Community and Individual Adjustment Disillusionment Level of Adjustment Previous Level of Adjustment “Second Disaster” Time Weeks Months (Raphael [1986] “When disaster strikes”) Phases of Response to Major Trauma