Qi Wei, Gevonden Martin, Shalev Arieh
Department of Psychiatry, New York University School of Medicine, 1 Park Ave, 8th Floor, 8-256, New York, USA.
Curr Psychiatry Rep. 2016 Feb;18(2):20. doi: 10.1007/s11920-015-0655-0.
Post-traumatic stress disorder (PTSD) is a frequent, tenacious, and disabling consequence of traumatic events. The disorder's identifiable onset and early symptoms provide opportunities for early detection and prevention. Empirical findings and theoretical models have outlined specific risk factors and pathogenic processes leading to PTSD. Controlled studies have shown that theory-driven preventive interventions, such as cognitive behavioral therapy (CBT), or stress hormone-targeted pharmacological interventions, are efficacious in selected samples of survivors. However, the effectiveness of early clinical interventions remains unknown, and results obtained in aggregates (large groups) overlook individual heterogeneity in PTSD pathogenesis. We review current evidence of PTSD prevention and outline the need to improve the disorder's early detection and intervention in individual-specific paths to chronic PTSD.
创伤后应激障碍(PTSD)是创伤性事件常见、顽固且致残的后果。该障碍可识别的起病和早期症状为早期发现和预防提供了机会。实证研究结果和理论模型已概述了导致PTSD的特定风险因素和致病过程。对照研究表明,理论驱动的预防性干预措施,如认知行为疗法(CBT)或针对应激激素的药物干预,在部分幸存者样本中是有效的。然而,早期临床干预的有效性尚不清楚,而且在总体(大群体)中获得的结果忽略了PTSD发病机制中的个体异质性。我们回顾了当前PTSD预防的证据,并概述了在个体特异性的慢性PTSD发展路径中改善该障碍早期发现和干预的必要性。