Editing Post-traumatic stress disorder (section)

== Prevention ==
{{See also|Traumatic memories}}
Modest benefits have been seen from early access to [[cognitive behavioral therapy]]. [[Critical incident stress management]] has been suggested as a means of preventing PTSD, but subsequent studies suggest the likelihood of its producing negative outcomes.<ref>{{cite journal |title=Disaster-related post-traumatic stress in police officers: A field study of the impact of debriefing |journal=Stress Medicine |volume=14 |issue=3 |pages=143–8 |vauthors=Carlier IV, Lamberts RD, van Uchelen AJ, Gersons BP |year=1998 |doi=10.1002/(SICI)1099-1700(199807)14:3<143::AID-SMI770>3.0.CO;2-S}}</ref><ref>{{cite journal |vauthors=Mayou RA, Ehlers A, Hobbs M |title=Psychological debriefing for road traffic accident victims. Three-year follow-up of a randomised controlled trial |journal=The British Journal of Psychiatry |volume=176 |issue=6 |pages=589–93 |date=June 2000 |pmid=10974967 |doi=10.1192/bjp.176.6.589 |doi-access=free}}</ref> A 2019 Cochrane review did not find any evidence to support the use of an intervention offered to everyone, and that "multiple session interventions may result in worse outcome than no intervention for some individuals."<ref name="Roberts_2019">{{cite journal |vauthors=Roberts NP, Kitchiner NJ, Kenardy J, Robertson L, Lewis C, Bisson JI |title=Multiple session early psychological interventions for the prevention of post-traumatic stress disorder |journal=[[Cochrane Library|The Cochrane Database of Systematic Reviews]] |volume=2019 |pages=CD006869 |date=August 2019 |issue=8 |pmid=31425615 |pmc=6699654 |doi=10.1002/14651858.CD006869.pub3}}</ref> The [[World Health Organization]] recommends against the use of [[benzodiazepines]] and [[antidepressants]] in for acute stress (symptoms lasting less than one month).<ref name=WHO2013>{{cite book |title=Assessment and Management of Conditions Specifically Related to Stress |year=2013 |isbn=978-92-4-150593-2 |url=http://apps.who.int/iris/bitstream/10665/85623/1/9789241505932_eng.pdf |access-date=2014-01-29 |url-status=live |publisher=World Health Organization |location=Geneva |archive-url=https://web.archive.org/web/20140201192439/http://apps.who.int/iris/bitstream/10665/85623/1/9789241505932_eng.pdf |archive-date=2014-02-01}}</ref> Some evidence supports the use of [[hydrocortisone]] for prevention in adults, although there is limited or no evidence supporting [[propranolol]], [[escitalopram]], [[temazepam]], or [[gabapentin]].<ref>{{cite journal |vauthors=Amos T, Stein DJ, Ipser JC |title=Pharmacological interventions for preventing post-traumatic stress disorder (PTSD) |journal=[[Cochrane Library|The Cochrane Database of Systematic Reviews]] |volume=2014 |issue=7 |pages=CD006239 |date=July 2014 |pmid=25001071 |doi=10.1002/14651858.CD006239.pub2|doi-access=free |pmc=11064759 }}</ref><ref>{{Cite journal |last1=Bertolini |first1=Federico |last2=Robertson |first2=Lindsay |last3=Bisson |first3=Jonathan I |last4=Meader |first4=Nicholas |last5=Churchill |first5=Rachel |last6=Ostuzzi |first6=Giovanni |last7=Stein |first7=Dan J |last8=Williams |first8=Taryn |last9=Barbui |first9=Corrado |date=2022-02-10 |editor-last=Cochrane Common Mental Disorders Group |title=Early pharmacological interventions for universal prevention of post-traumatic stress disorder (PTSD) |journal=Cochrane Database of Systematic Reviews |language=en |volume=2022 |issue=2 |pages=CD013443 |doi=10.1002/14651858.CD013443.pub2 |pmc=8829470 |pmid=35141873}}</ref>

=== Psychological debriefing ===
{{see also|Debriefing#Crisis intervention}}

Trauma-exposed individuals often receive treatment called ''psychological debriefing'' in an effort to prevent PTSD, which consists of interviews that are meant to allow individuals to directly confront the event and share their feelings with the counselor and to help structure their memories of the event.<ref name=AHRQ2013/> However, several [[Meta-analysis|meta-analyses]] find that psychological debriefing is unhelpful, is potentially harmful and does not reduce the future risk of developing PTSD.<ref name="Shalev 2017" /><ref name=AHRQ2013>{{cite book |vauthors=Gartlehner G, Forneris CA, Brownley KA, Gaynes BN, Sonis J, Coker-Schwimmer E, Jonas DE, Greenblatt A, Wilkins TM, Woodell CL, Lohr KN |title=Interventions for the Prevention of Posttraumatic Stress Disorder (PTSD) in Adults After Exposure to Psychological Trauma |chapter=Discussion |date=2013 |publisher=Agency for Healthcare Research and Quality (US) |url=https://www.ncbi.nlm.nih.gov/books/NBK133347 |pmid=23658936}}</ref><ref name=Feldner2007>{{cite journal |vauthors=Feldner MT, Monson CM, Friedman MJ |title=A critical analysis of approaches to targeted PTSD prevention: current status and theoretically derived future directions |journal=Behavior Modification |volume=31 |issue=1 |pages=80–116 |date=January 2007 |pmid=17179532 |doi=10.1177/0145445506295057 |citeseerx=10.1.1.595.9186 |s2cid=44619491}}</ref><ref>{{cite journal |vauthors=Rose S, Bisson J, Churchill R, Wessely S |title=Psychological debriefing for preventing post traumatic stress disorder (PTSD) |journal=[[Cochrane Library|The Cochrane Database of Systematic Reviews]] |issue=2 |pages=CD000560 |date=2002 |pmid=12076399 |doi=10.1002/14651858.CD000560 |pmc=7032695}}</ref> This is true for both single-session debriefing and multiple session interventions.<ref name="Roberts_2019" /> As of 2017 the [[American Psychological Association]] assessed psychological debriefing as ''No Research Support/Treatment is Potentially Harmful''.<ref>{{cite web |title=Psychological Debriefing for Post-Traumatic Stress Disorder |url=https://www.div12.org/psychological-treatments/treatments/psychological-debriefing-for-post-traumatic-stress-disorder/ |website=www.div12.org |date=19 August 2014 |publisher=[[Society of Clinical Psychology]]: Division 12 of The American Psychological Association |access-date=9 September 2017}}</ref>

=== Early intervention ===
Trauma focused intervention delivered within days or weeks of the potentially traumatic event has been found to decrease PTSD symptoms.<ref>{{cite journal |vauthors=Birur B, Moore NC, Davis LL |title=An Evidence-Based Review of Early Intervention and Prevention of Posttraumatic Stress Disorder |journal=[[Community Mental Health Journal]] |volume=53 |issue=2 |pages=183–201 |date=February 2017 |pmid=27470261 |doi=10.1007/s10597-016-0047-x |s2cid=28150745}}</ref> Similar to psychological debriefing, the goal of early intervention is to lessen the intensity and frequency of stress symptoms, with the aim of preventing new-onset or relapsed mental disorders and further distress later in the healing process.<ref>{{cite journal |vauthors=Litz B |title=Early intervention for trauma and loss: overview and working care model |journal=[[European Journal of Psychotraumatology]] |volume=6 |issue=1 |pages=28543 |date=2015-12-01 |pmid=26073207 |pmc=4466306 |doi=10.3402/ejpt.v6.28543}}</ref>

=== Risk-targeted interventions ===
{{For|one such method|trauma risk management}}
Risk-targeted interventions are those that attempt to mitigate specific formative information or events. It can target modeling normal behaviors, instruction on a task, or giving information on the event.<ref name=Wiseman2013Rev>{{cite journal |vauthors=Wiseman T, Foster K, Curtis K |title=Mental health following traumatic physical injury: an integrative literature review |journal=[[Injury (journal)|Injury]] |volume=44 |issue=11 |pages=1383–90 |date=November 2013 |pmid=22409991 |doi=10.1016/j.injury.2012.02.015}}</ref><ref name=Kassam-Adams2013Rev>{{cite journal |vauthors=Kassam-Adams N, Marsac ML, Hildenbrand A, Winston F |title=Posttraumatic stress following pediatric injury: update on diagnosis, risk factors, and intervention |journal=[[JAMA Pediatrics]] |volume=167 |issue=12 |pages=1158–65 |date=December 2013 |pmid=24100470 |doi=10.1001/jamapediatrics.2013.2741}}</ref>