School of Psychology, University of New South Wales, Australia.
Clin Psychol Rev. 2021 Apr;85:101981. doi: 10.1016/j.cpr.2021.101981. Epub 2021 Jan 24.
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.
虽然有许多尝试通过创伤暴露后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适度的成功。本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。本文回顾了 PTSD 的主要预测因素，并重点介绍了可能构成从急性应激反应向 PTSD 发展的潜在机制。本综述强调，有广泛的生物学和认知因素已被证明可预测 PTSD。尽管如此，早期干预的主要尝试还是集中在试图增强消除过程或改变急性期评估的策略上。 PTSD 的有记录预测因素表明，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 PTSD 有大量急性预测因素，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。
