The question of trauma has been central to psychiatric practice for a century. The issue has become culturally important both with the rise of feminism, and attention to childhood sexual abuse, and with continued experience with wars, where military combat trauma remains a major problem.
The special article this month examines the concept of trauma as it has evolved historically and as it has progressed in clinical practice today. Most of the focus is on civilian trauma. Future issues will address trauma specific to military settings.
The importance of distinguishing stressful life events from traumata is emphasized. We examine ways in which PTSD can be identified and distinguished from other conditions. We describe how most traumatic experiences do not lead to later PTSD, which leads to the importance of baseline biological susceptibility and the concept of resilience. The PL emphasis is on avoiding using medications excessively for PTSD, which is common practice.
As usual citations and references can be found in the text.
The classic study of the month examines a unique test of whether the presence of trauma predicts PTSD. The drug of the month is propranolol, a versatile drug, which has potential uses in PTSD and other important arousal settings, such as akathisia. The case of the month examines a scenario in which stressful life events are misinterpreted as traumata, and where a mood disease is misdiagnosed as PTSD.
Keep reading, and send us your comments.
Nassir Ghaemi MD, Editor
New truths begin as heresies and end as superstitions - T. H. Huxley