Biomedical Engineering Reference
In-Depth Information
Physical assaults occur in the context of commu-
nity violence (2 million women, 3
illness or medical disabilities; refugees), under-
served (e.g., monolingual non-English speaking,
older adults) or resilient but cumulative affected
(e.g., first responders) populations (see literature
review above). Training and supervision for CRRT
personnel included not only technical skills for
assessment and intervention, but also informa-
tion about the operational procedures for actual
emergencies—with an emphasis on the need for
operational flexibility as critical to making
in-situ
adaptations to unanticipated events.
million men;
Kilpatrick & Acierno, 2003) and domestic violence
(3
+
million annually; Frank & Rodowski, 1999),
the latter affecting more than two million child-
ren as witnesses annually (Mitchell & Finkelhor,
2001). More than 2.5 million people are hospital-
ized as a result of injuries each year in the United
States (Zatzick et al., 2002).
Post-traumatic stress symptoms are virtually
universal in the first hours and days after exposure
to traumatic stressors, but fortunately most such
symptoms remit within the first 2-4 weeks [9].
PTSD often co-occurs with other mental health
problems following disaster or potentially trau-
matic accidents or assaults, and there is prelimi-
nary evidence that PTSD precedes the other mental
health sequelae (McMillen et al., 2002). Most
immediately in the wake of a potentially traumatic
disaster, accident, or assault, acute stress reactions
occur universally although in variable and individ-
ualized forms [1,2,9]. Risk factors associated with
the individual (e.g., gender, ethnicity, age, biolog-
ical stress-reactivity, preparation and training,
access to socioeconomic resources and social
support) and the community (e.g., pre- and post-
trauma socioeconomic resources,
+
11.2.7.6 Information technology system
CTRP developed a sustainable information tech-
nology infrastructure (Chandrasekhar & Ghosh,
2001), the Behavioral Health Regional Crisis
Response Information System (BHRCRIS). The
BHRCRIS supports a web-based database holding
all pertinent information necessary to ensure an
organized system for mobilization and deploy-
ment of CRRTs and CPCs on the CTRP website.
The BHRCRIS enables the dissemination and
tracking of information regarding team activi-
ties, related activities of DMHAS/DCF, selected
training opportunities, and resources related to
trauma and behavioral health crisis response.
religious and
cultural institutions).
A study of survivors of sexual assault (Roth-
baum, Foa, Riggs, Murdock, &Walsh, 1992) found
that 94% met all but the duration criteria for PTSD
at an average of 14 days post-trauma. A study
with nonsexual assault survivors (Riggs, Rothbaum
& Foa, 1995) reported that 50% of the men and
70% of the women met all but the duration criteria
for PTSD at an average of 19 days post-trauma.
However, after another 3-4 months only 21% of
the female assault survivors, 0% of the male assault
survivors, and 47% of the female sexual assault
survivors met criteria for PTSD. Bryant [9] also
identified a 5% incidence rate of delayed PTSD
(i.e., meeting diagnostic criteria at 2-year follow-up
but not at 6-month follow-up) in a sample of motor
vehicle accident survivors, and found that these
individuals had elevated (although diagnostically
sub-threshold) levels of PTSD symptoms at earlier
assessment time points [an incidence level similar
11.3 Longterm Psychiatric Services
in the Wake of Bioterrorism: After the
Heroic/Honeymoon Phases
11.3.1 Post Traumatic Stress Disorder
(PTSD): Course and Comorbidity
More than half of all American adults report
having experienced at least one traumatic stressor,
and approximately one in 20 men and one in 10
women develop PTSD at some time in their lives
(Kessler, Sonnega, Bromet, Hughes & Nelson,
1995). Witnessing a severe injury or death (35.6%
of men, 14.5% of women) and being in a life-
threatening accident (25% of men, 14% of women)
were the most prevalent types of trauma exposure
reported. Although somewhat less prevalent, being
the victim of a physical assault or rape (11-12%
of men; 9-16% of women) also was prevalent.
