Editing Neurosis (section)

== Prevention ==
{{Main|Stress management|Traumatic memories|Psychological resilience}}
[[File:Transactional_Model_of_Stress_and_Coping_-_Richard_Lazarus.svg|thumb|Transactional Model of Stress and Coping of [[Richard Lazarus]] and [[Susan Folkman]].]]

{{See also|Human resource management|Family therapy|Social work}}

[[Stress inoculation training]] was developed to reduce anxiety in doctors during times of intense stress by [[Donald Meichenbaum]].<ref name="Meichenbaum_2009">{{cite book | vauthors = Meichenbaum D | date = 2009 | chapter = Stress inoculation training. | veditors = O'Donohue WT, Fisher JE | title = General principles and empirically supported techniques of cognitive behavior therapy | pages = 627–630 | publisher = John Wiley & Sons, Inc. | isbn = 978-0-470-22777-0 | via = PsycNET |url=https://psycnet.apa.org/record/2009-02305-071}}</ref> It is a combination of techniques including [[Relaxation (psychology)|relaxation]], [[Positive psychology|negative thought suppression]], and [[Exposure therapy|real-life exposure to feared situations]] used in PTSD treatment.<ref name="Sharpless">{{cite journal | vauthors = Sharpless BA, Barber JP | title = A Clinician's Guide to PTSD Treatments for Returning Veterans | journal = Professional Psychology, Research and Practice | volume = 42 | issue = 1 | pages = 8–15 | date = February 2011 | pmid = 21475611 | pmc = 3070301 | doi = 10.1037/a0022351}}</ref> The therapy is divided into four phases and is based on the principles of [[cognitive behavioral therapy]].<ref name="Meichenbaum_2009"/> The first phase identifies the individual's specific reaction to stressors and how they manifest into symptoms. The second phase helps teach techniques to regulate these symptoms using relaxation methods. The third phase deals with specific coping strategies and positive cognitions to work through the stressors. Finally, the fourth phase exposes the client to imagined and real-life situations related to the traumatic event.<ref>{{Cite web |title=Stress Inoculation Training |url=https://www.ptsd.va.gov/apps/decisionaid/resources/PTSDDecisionAidSIT.pdf |website=VA PTSD}}</ref> This training helps to shape the response to future triggers to diminish impairment in daily life.

Patients with [[acute stress disorder]] (ASD) have been found to benefit from [[cognitive behavioral therapy]] in preventing [[Post-traumatic stress disorder|PTSD]], with clinically meaningful outcomes at six-month follow-up consultations. Supportive counseling was outperformed by a regimen of relaxation, [[cognitive restructuring]], imaginal exposure, and in-vivo exposure.<ref>{{cite book |title=Bergin and Garfield's Handbook of Psychotherapy and Behavioral Change |publisher=Wiley |year=2004 | veditors = Lambert MJ |location=New York}}{{page needed|date=October 2017}}</ref> Programs based on mindfulness-based stress reduction also seem to be useful at managing stress.<ref name="Sharma">{{cite journal | vauthors = Sharma M, Rush SE | title = Mindfulness-based stress reduction as a stress management intervention for healthy individuals: a systematic review | journal = Journal of Evidence-Based Complementary & Alternative Medicine | volume = 19 | issue = 4 | pages = 271–286 | date = October 2014 | pmid = 25053754 | doi = 10.1177/2156587214543143 | doi-access = free}}</ref>

[[Progressive muscle relaxation]] (PMR) was developed by [[Edmund Jacobson]].<ref name=":7" /> PMR involves learning to relieve the tension in specific muscle groups by first tensing and then relaxing each muscle group.<ref name=":42" /> When the muscle tension is released, attention is directed towards the differences felt during tension and relaxation so that the patient learns to recognize the contrast between the states.<ref name=":5" /><ref name=":8" /> This reduces anxiety.<ref name=":15" />

Playing [[Tetris]] shortly after a traumatic experience prevents the development of PTSD in some cases.<ref>{{cite press release |title=Tetris used to prevent post-traumatic stress symptoms |url=https://www.psych.ox.ac.uk/news/tetris-used-to-prevent-post-traumatic-stress-symptoms |publisher=NIHR Oxford Health Biomedical Research Centre |date=3 April 2017 }}</ref>

[[Stanley Rachman]] compiled lists of factors that promote or impede "emotional processing" in 1980, the former reducing the development of neurosis, the latter making it more likely.<ref name=":1" />

[[Aaron Antonovsky]] stated that a resilient person is more likely to appraise a situation as "meaningful, predictable, and ordered."<ref name=":3" />

[[Michael Rutter]] found that resilience could be improved in an individual by the 1) reduction of risk impact, 2) reduction of negative chain reactions, 3) establishment and maintenance of self-esteem and self-efficacy, and 4) opening up of opportunities.<ref name=":4">{{cite journal | vauthors = Rutter M |title=Psychosocial resilience and protective mechanisms. |journal=American Journal of Orthopsychiatry |date=July 1987 |volume=57 |issue=3 |pages=316–331 |doi=10.1111/j.1939-0025.1987.tb03541.x |pmid=3303954 }}</ref>

The use of pharmaceuticals to mitigate the consequences of ASD has made some progress. The [[Alpha-1 blocker]] [[Prazosin]], which controls sympathetic response, can be administered to patients to help them unwind and enable better sleep.<ref>{{cite book | vauthors = Fanai M, Khan MA | chapter = Acute Stress Disorder |date=2021 |chapter-url=http://www.ncbi.nlm.nih.gov/books/NBK560815/ | title = StatPearls |access-date=2021-03-14 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=32809650}}</ref> It is unclear how it functions in this situation. Following a traumatic experience, [[hydrocortisone]] (cortisol) has demonstrated some promise as an early prophylactic intervention, frequently slowing the onset of PTSD.<ref>{{cite journal | vauthors = Astill Wright L, Sijbrandij M, Sinnerton R, Lewis C, Roberts NP, Bisson JI | title = Pharmacological prevention and early treatment of post-traumatic stress disorder and acute stress disorder: a systematic review and meta-analysis | journal = Translational Psychiatry | volume = 9 | issue = 1 | pages = 334 | date = December 2019 | pmid = 31819037 | pmc = 6901463 | doi = 10.1038/s41398-019-0673-5 | doi-access = free}}</ref>

In a systematic literature review in 2014, the [[Swedish Agency for Health Technology Assessment and Assessment of Social Services]] (SBU) found that a number of work environment factors could affect the risk of developing [[Occupational burnout|exhaustion disorder]] or depressive symptoms:

* People who experience a work situation with little opportunity to influence, in combination with too high demands, develop more depressive symptoms.
* People who experience a lack of compassionate support in the work environment develop more symptoms of depression and exhaustion disorder than others. Those who experience bullying or conflict in their work develop more depressive symptoms than others, but it is not possible to determine whether there is a corresponding connection for symptoms of exhaustion disorder.
* People who feel that they have urgent work or a work situation where the reward is perceived as small in relation to the effort develops more symptoms of depression and exhaustion disorder than others. This also applies to those who experience insecurity in the employment, for example concerns that the workplace will be closed down.
* In some work environments, people have less trouble. People who experience good opportunities for control in their own work and those who feel that they are treated fairly develop less symptoms of depression and exhaustion disorder than others.
* Women and men with similar working conditions develop symptoms of depression as much as exhaustion disorder.<ref>{{Cite web |work = Statens beredning för medicinsk och social utvärdering (SBU) | trans-work = Swedish Agency for Health Technology Assessment and Assessment of Social Services|date=2014-02-19 |title=Arbetsmiljöns betydelse för symtom på depression och utmattningssyndrom |url=https://www.sbu.se/sv/publikationer/SBU-utvarderar/arbetsmiljons-betydelse-for-symtom-pa-depression-och-utmattningssyndrom/ |access-date=2022-07-15 |language=sv}}</ref>