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This page contains information and summaries of
published research that are intended for people with professional training in
mental health. We urge caution since
it may be difficult to know how to interpret the information without advanced
training in psychology or psychiatry.
We recommend that readers interested in information intended for
the general public check other areas of this web site (such as Info
for Adults or Info
for Children). They contain similar information, but in a more readable
form. Also, elsewhere we have provided links
to other websites that we feel may be helpful.
Psychosocial Interventions Initiated from 48 hrs to 2
weeks Following a Trauma
(for
treatment of Acute Stress Disorder and Prevention of PTSD)
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Abbreviated Variant
of Prolonged Exposure
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Modest by growing body
of RCTs. 86-92% of treated group was PTSD-free, vs. 26-44% of control
group (which was either untreated or got supportive counseling).
At six months, 83-85% of PE
participants had no PTSD, vs. 30-33% of those who received supportive
counseling (see Foa et al., 1995; Bryant et al., 1988;
Bryant et al., 1999).
Also markedly reduced incidence of depression.
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Critical Incident
Stress Debriefing (CISD) & variants
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There is no empirical
support for assertions that CISD prevents PTSD or improves outcomes (Deahl
et al., 2000; Carlier et al, 2000; Harris et al., 2002, van Emmerik et
al., 2002), and there have been some results that point to the possibility
of harm (Mayou et al, 2000). There
is no support from RCTs that CISD is effective in preventing PTSD (Ruzek
et al., 2001). Before
considering debriefing or CISD consider risks carefully, given that there
are few benefits and preliminary data on risk of harm.
That said, even though CISD may not appropriate, some form of early
education, screening, and support may be useful.
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Disclosure
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There
are suggestions that client-initiated self-disclosure, including writing
or talking to a tape recorder (vs. structured debriefing) may be
associated with reduced levels of distress (Pennebaker, 2002)
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EMDR
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No clinical trials
published
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Benzodiazepines
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No support for
efficacy of benzodiazepines in preventing PTSD (Gelpin et al., 1996).
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Propanolol
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Study by Pitman et al.
(cited in Ruzek et al., 2001) of administration within 6 hours of trauma.
Reduced physiological responses to trauma-related mental imagery,
but only a statistically non-significant trend for reducing Sx of PTSD.
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The
information on medication provided in this chart is from standard
references. We are not psychiatrists or psychopharmacologists, and (as
with all information on this website) the information that follows should not be
construed as advice or as a professional recommendation. We strongly
encourage people interested in learning about psychopharmacology and PTSD or ASD
to consult with a psychiatrist or psychopharmacologist.
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