reaction to trauma: myths and realities professor david a alexander ma(hons), c.psychol, phd, fbps,...
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REACTION TO REACTION TO TRAUMA: MYTHS TRAUMA: MYTHS AND REALITIESAND REALITIESProfessor 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)
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
• 10% of all deaths in UK
• leading cause of death in young people
• for every death two permanently disabled
• high economic cost
‘The trauma epidemic’
How common are post-traumatic conditions?
Best estimates (Alexander, 1997)
• Burn injuries - 45%
• RTAs - 18%
• Industrial accidents - 18%
• Major disasters - 50%
• Rape - 50%
HOW DO PEOPLE REACT HOW DO PEOPLE REACT AFTER TRAUMA?AFTER TRAUMA?
Individual reactions
Emotional Cognitive
SocialPhysical
Individual reactions
Emotional
NumbnessFearDepressionGuiltAngerHelpless
Individual reactions
Cognitive
False beliefsLoss of faithMemory/
concentrationFlashbacks
Individual reactions
SocialAvoidanceIrritabilityWithdrawal
Individual reactions
Physical
HyperarousalSleep 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
HAVE YOU SOMEONE TO HAVE YOU SOMEONE TO GO HOME TO...?GO HOME TO...?
• eviction
• leukaemic daughter
• redundancy
• physical ill health
• pending divorce
Yes, but...
A team of trained counsellors is standing
by…
““WATCHFUL WAITING”WATCHFUL WAITING”
Phases of Response to Major Trauma
Warning
Impact
“Honeymoon”
Level of
Adju
stm
ent
Time Weeks Months
Previous Level of Adjustment
(Raphael [1986] “When disaster strikes”)
Disillusionment Enhanced Community and Individual Adjustment
“Second Disaster”