Trauma and Disaster Responses and Management

by Ursano, Robert J.

• ISBN13: 9781585621156
• ISBN10: 1585621153
• Edition: 1st
• Format: Paperback
• Copyright: 2003-04-01
• Publisher: AMERICAN PSYCHIATRIC PUBLISHING INC

Summary

In our increasingly dangerous world-brought into urgent focus by the September 11, 2001, attacks-the need to manage the psychiatric consequences of traumatic events and disasters has never been greater. The editors of this powerful reference summarize our current understanding of the complex psychological, behavioral, and social responses to disaster, and present a compelling case for intensifying our focus on delivery and intervention efforts. In just five chapters, 16 distinguished contributors examine the impact of trauma from the personal to the community level. This critical book reviews the neurobiologic and neuroanatomic responses to severe traumatic events, focusing on posttraumatic stress disorder to show how an initially adaptive response becomes maladaptive by producing long-term adverse consequences. discusses the psychiatric epidemiology of disaster, presenting a guide for clinicians in identifying and following groups at high risk for developing psychiatric disorders and an empirical blueprint for developing community interventions. details the impact of traumatic stressors on children, using the 9/11 terrorist attacks to illustrate many points and debunking the myth that children are more resilient than adults-thus reinforcing their assertion that we need to improve the delivery of mental health services to traumatized children. presents material from an international consensus conference on the psychological interventions following mass violence, reviewing the psychological impact of disasters (including risk and protective factors) and acute interventions for trauma (e.g., psychological debriefing, treatment of traumatic grief, pharmacotherapy, cognitive-behavioral therapy, and interventions for children). concludes with the special dilemmas posed by weapons of mass destruction, including chemical, biological, nuclear, radiological, and high-yield explosives, discussing the attributes that make these weapons especially effective as instruments of terror and offering recommendations on how nations can enhance preparedness against these weapons. This volume is a must-read for educators, students, residents, clinicians, and social workers-in short, anyone interested in helping to heal the psychological fallout from traumatic events and disasters.

Author Biography

Robert J. Ursano, M.D., is Professor and Chairman in the Department of Psychiatry at F. Herbert School of Medicine of Uniformed Services University of the Health Sciences in Bethesda, Maryland.

Ann E. Norwood, M.D., is Associate Professor and Associate Chair in the Department of Psychiatry at F. Herbert School of Medicine of Uniformed Services University of the Health Sciences in Bethesda, Maryland.

Table of Contents

Contributors	ix
Introduction to the Review of Psychiatry Series	xiii
John M. Oldham
Michelle B. Riba
Preface	xvii
Robert J. Ursano
Ann E. Norwood
Neurobiological Mechanisms of Psychological Trauma	1	(36)
Omer Bonne
Alexander Neumeister
Dennis S. Charney
Phenomenology and Classification	1	(3)
Neural Mechanism and Functional Neuroanatomy of PTSD	4	(11)
Neuroendocrinology and Neurochemistry of Stress and PTSD	15	(15)
Conclusions	30	(1)
References	30	(7)
Psychiatric Epidemiology of Disaster Responses	37	(26)
Carol S. North
Disaster Trauma Theory	37	(5)
Types of Postdisaster Mental Health Response	42	(7)
Postdisaster Populations	49	(2)
The Course of Postdisaster Mental Health Response	51	(1)
Bioterrorism: A Unique Form of Intentional Disaster	52	(1)
Directions for Postdisaster Interventions Based on Epidemiological Research	53	(2)
References	55	(8)
Children, Disasters, and the September 11th World Trade Center Attack	63	(34)
Roy Lubit
Spencer Eth
What Is a Disaster?	65	(3)
Psychiatric Sequelae of Disasters	68	(4)
Impact of Disasters on Emotional Development	72	(6)
Impact of Disasters on Families, Schools, and Communities	78	(2)
September 11	80	(7)
Lessons to Remember	87	(3)
References	90	(7)
Early Intervention for Trauma-Related Problems	97	(28)
Patricia J. Watson
Matthew J. Friedman
Laura E. Gibson
Josef I. Ruzek
Fran H. Norris
Elspeth Cameron Ritchie
Empirical Literature on the Effects of Disasters	98	(4)
Key Components of Early Intervention	102	(2)
General Recommendations	104	(1)
Psychological Debriefing	105	(4)
Cognitive-Behavioral Interventions	109	(3)
Eye Movement Desensitization and Reprocessing	112	(1)
Traumatic Grief	112	(1)
Early Interventions for Children Exposed to Mass Violence or Disasters	113	(1)
Pharmacotherapy	114	(2)
Conclusions	116	(3)
References	119	(6)
Terrorism With Weapons of Mass Destruction: Chemical, Biological, Nuclear, Radiological, and Explosive Agents	125	(30)
Robert J. Ursano
Ann E. Norwood
Carol S. Fullerton
Harry C. Holloway
Molly Hall
Terrorism	126	(1)
Weapons of Mass Destruction	127	(1)
Role of Psychiatrists	128	(10)
Psychiatric Morbidity in the Wake of Events Involving CBRNE Agents	138	(2)
Behavioral Responses to CBRN Agents: Areas of Special Concern	140	(5)
Risk Communication	145	(2)
Special Issues Associated With Bioterrorism	147	(3)
Conclusions	150	(1)
References	151	(4)
Index	155