Sep. 19, 2003 As ordinary citizens struggled to rebuild their lives after the collapse of the World Trade Center towers, well-meaning mental health professionals swarmed New York City to provide aid to the expected millions who would surely need support. These grief and crisis counselors delivered interventions that they believed would mitigate psychological distress and prevent the emergence of posttraumatic stress disorder.
The most widely used PTSD intervention, psychological debriefing, seeks to prevent symptoms by having trauma survivors share memories or relive the experience. Unfortunately, a number of scientific studies have raised substantial concerns about the actual impact this and similar methods. A new report examining the current body of research on the efficacy of psychological debriefing found "no convincing evidence that debriefing reduces the incidence of PTSD, and some controlled studies suggest that it may impede natural recovery from trauma."
The report, "Does Early Psychological Intervention Promote Recovery From Posttraumatic Stress?" appears in the November issue of Psychological Science in the Public Interest, a journal of the American Psychological Society. The authors are Richard J. McNally, Harvard University; Richard A. Bryant, University of New South Wales; and Anke Ehlers, Institute of Psychiatry, King's College London.
While most people who participate in psychological debriefing say it was helpful, controlled studies showed little or no effect on the onset of PTSD. "These reports that the method is helpful may reflect little more than polite expressions of gratitude for attention received," the authors wrote. "Most studies show that individuals who receive debriefing fare no better than those who do not receive debriefing."
According to the authors, the vast majority of trauma survivors recover from initial posttrauma reactions without professional help. Other factors, such as a family history of mental illness, one's social network of family and friends, and varying ways in which people process stressful stimuli appear to be more directly correlated to the manifestation of PTSD.
"The efficacy of interventions designed to mitigate acute distress and prevent long-term psychopathology, such as PTSD, needs to be evaluated against the effects of natural recovery," the authors wrote.
PTSD typically follows a "horrific, life-threatening event such as combat, rape, or earthquakes" and is characterized by re-experiencing symptoms, emotional numbing, avoidance of reminders of the trauma, and hyperarousal.
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