REACTION TO
TRAUMA: MYTHS
AND REALITIES
Professor 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
‘The trauma epidemic’
• 10% of all deaths in UK
• leading cause of death in young people
• for every death two permanently disabled
• high economic cost
How common are posttraumatic conditions?
Best estimates (Alexander, 1997)
• Burn injuries
-
45%
• RTAs
-
18%
• Industrial accidents
-
18%
• Major disasters
-
50%
• Rape
-
50%
HOW DO PEOPLE REACT
AFTER TRAUMA?
Individual reactions
Emotional
Cognitive
Social
Physical
Individual reactions
Emotional
Numbness
Fear
Depression
Guilt
Anger
Helpless
Individual reactions
Cognitive
False beliefs
Loss of faith
Memory/ concentration
Flashbacks
Individual reactions
Social
Avoidance
Irritability
Withdrawal
Individual reactions
Physical
Hyperarousal
Sleep problems
At risk factors include...
Trauma
Survivor
• sudden, unexpected
• previous trauma
• man made
• psychiatric history
• (perceived) threat to life
• severity (meaning) of
injury
• extended exposure
• multiple
deaths/mutilations
• lack of support
• other stresses
HAVE YOU SOMEONE TO
GO HOME TO...?
Yes, but...
• eviction
• leukaemic daughter
• redundancy
• physical ill health
• pending divorce
A team of trained
counsellors is standing by…
“WATCHFUL WAITING”
Phases of Response
to Major Trauma
Level of Adjustment
“Honeymoon”
Impact
Warning
Disillusionmen
t
Enhanced Community and
Individual Adjustment
Previous Level of
Adjustment
“Second Disaster”
Time
Weeks
Months
(Raphael [1986] “When disaster strikes”)