Survivors of Disasters, Victims of Post Traumatic Stress Disorder
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چکیده
A patient arrives alert and conscious to the Trauma Center at the Dartmouth Hitchcock Medical Center (DHMC). As an adult Hispanic woman with no preexisting psychological condition, she is unremarkable save for the fact that she has survived an acute life-threatening event. She is interviewed upon arrival and administered a series of tests to quantitatively assess her injuries. This process is the beginning of a screening phase: it is ascertained that the patient can recall her trauma; that she can call to mind having reacted to the experience with fear, helplessness, or horror; and that she presents no signs of traumatic brain injury (Mellman et al, 2001). Fortunately, her physical wounds heal with time but, a month later, she is still suffering from psychological damage. Post Traumatic Stress Disorder (PTSD) has long been recognized as a problem for battle-scarred soldiers or survivors of major natural disasters (Weisberg, 2000). This, however, masks the fact that the disorder is far more common, with approximately one-third of the individuals hospitalized for traumatic injuries expected to develop symptoms of PTSD (Mellman, 2001). Severe traumatic injury is an important antecedent to PTSD and encompasses not only events like military combat, but also sexual assault, motor vehicle crashes, and industrial accidents. I was privileged to contribute to the second phase of a study under the guidance of Thomas Mellman M.D., at the Dartmouth-Hitchcock Medical Center that aims to identify early predictors of PTSD related to severe traumatic injury. The objective of Dr. Mellman’s work is to better understand the mechanisms of early pathogenesis with the ultimate goal being the development of preventive interventions (Mellman et al, 2001). Part of the motivation for such a study is the fact that, once established, PTSD is often chronic, demonstrating a low probability of remission if untreated. Furthermore, the syndrome is linked with an increased likelihood of co-occurring psychiatric disorders including depression, phobias, troubled interpersonal relationships, and violent
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