Managing acute stress response to major trauma


In this article, the authors review the current empiric literature on early interventions. Findings on the effects, course, help-seeking, and recovery from disasters are first reviewed, with recommendations given that are pertinent to intervention following mass casualties. In reviewing the most commonly used interventions, it is clear that evidence from well-controlled studies showing that early intervention can help prevent longer-term problems is limited. The authors discuss the approaches that have received the most attention or empiric support as early interventions following trauma, which include psychologic debriefing, cognitive-behavioral interventions, eye movement desensitization and processing (EMDR) and other neoteric approaches, and psychopharmacology. At this time, the most promising results for prevention of psychopathology have been achieved with brief four- or five-session cognitive-behavioral therapy. In contrast, randomized clinical trials on psychologic debriefing currently suggest that this approach is either ineffective at preventing psychopathology, or contributive to PTSD symptoms. Research support is currently lacking for EMDR and pharmacotherapy as early interventions. A major challenge to the field is to integrate the practical experience and knowledge of professional responders with well-controlled, timely intervention research, and to effectively disseminate these findings to practitioners in the field.






Patricia J. Watson
Matthew J. Friedman
Josef I. Ruzek
Fran Norris

Original Work Citation

Watson, P. J., Friedman, M. J., Ruzek, J. I., & Norris, F. (2002, August). Managing acute stress response to major trauma. Current Psychiatry Reports, 4(4), 247-253. doi:10.1007/s11920-996-0043-x



“Managing acute stress response to major trauma,” Francine Shapiro Library, accessed September 23, 2021,

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