Prognosis

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Trauma survivors who receive critical incident stress debriefing as soon as possible after the event have the best prognosis for full recovery. For patients who devel op full-blown PTSD, a combination of peer-group meetings and individual psychotherapy are often effective. Treatment may require several years, however, and the patient is likely to experience relapses.

There are no studies of untreated PTSD, but long-term studies of patients with delayed-reaction PTSD or delayed diagnosis of the disorder indicate that treatment of patients in these groups is much more difficult and complicated.

In some patients, PTSD becomes a chronic mental disorder that can persist for decades, or the remainder of the patient's life. Patients with chronic PTSD often have a cyclical history of symptom remissions and relapses. This group has the poorest prognosis for recovery; some patients do not respond to any of the currently available treatments for PTSD.

Prevention

Some forms of trauma, such as natural disasters and accidents, can never be completely eliminated from human life. Traumas caused by human intention would require major social changes to reduce their frequency and severity, but given the increasing prevalence of PTSD around the world, these long-term changes are worth the effort. In the short term, educating people—particularly those in the helping professions—about the signs of critical incident stress may prevent some cases of exposure to trauma from developing into full-blown PTSD.

See also Anxiety reduction techniques; Bodywork therapies; Creative therapies; Exposure treatment; Somatization and Somatoform disorders

Resources BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition, text revised. Washington, DC: American Psychiatric Association, 2000.

Beers, Mark H., M.D., and Robert Berkow, M.D., eds. "Posttraumatic Stress Disorder." In The Merck Manual of Diagnosis and Therapy, 17th edition. Whitehouse Station, NJ: Merck Research Laboratories, 1999. Herman, Judith, M.D. Trauma and Recovery. 2nd ed., revised.

New York: Basic Books, 1997. Laub, Dori, M.D. "An Event Without A Witness: Truth, Testimony and Survival." In Testimony: Crises of Witnessing in Literature, Psychoanalysis, and History, written by Dori Laub, M.D. and Shoshana Felman. New York: Routledge, 1992.

ORGANIZATIONS

American Psychiatric Association. 1400 K Street NW, Washington D.C. 20005. <http://www.psych.org>.

Anxiety Disorders Association of America, Inc. 11900 r

Parklawn Drive, Suite 100, Rockville, MD 20852. (301) | 231-9350. <http://www.adaa.org>. t

International Critical Incident Stress Foundation, Inc. 10176

Baltimore National Pike, Unit 201, Ellicott City, MD j

21042. (410) 750-9600. Emergency: (410) 313-2473. <http://www.icisf.org>. jj

International Society for Traumatic Stress Studies. 60 Revere g-Drive, Suite 500, Northbrook, IL 60062. (847) 480-9028. n <http://www.istss.org>. National Center for PTSD. 1116D V.A. Medical Center, 215 N. Main Street, White River Junction, VT 05009-0001. (802) 296-5132. <http://www.ncptsd.org>. National Institute of Mental Health. 6001 Executive

Boulevard, Rm. 8184, MSC 9663, Bethesda, MD 208929663. (301) 443-4513. <http://www.nimh.nih.gov>.

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Anxiety and Panic Attacks

Anxiety and Panic Attacks

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