Journal of Rehabilitation Research & Development (JRRD)

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Volume 49 Number 5, 2012
   Pages 637 — 648

Abstract — Review of VA/DOD Clinical Practice Guideline on management of acute stress and interventions to prevent posttraumatic stress disorder

William P. Nash, MD;1 Patricia J. Watson, PhD2*
1Department of Psychiatry, University of California, San Diego, San Diego, CA; 2National Center for PTSD, White River Junction, VT; National Center for Child Traumatic Stress, Los Angeles, CA; and Dartmouth Medical School, Hanover, NH

Abstract–This article summarizes the recommendations of the Department of Veterans Affairs (VA)/Department of Defense (DOD) VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress that pertain to acute stress and the prevention of posttraumatic stress disorder, including screening and early interventions for acute stress states in various settings. Recommended interventions during the first 4 days after a potentially traumatic event include attending to safety and basic needs and providing access to physical, emotional, and social resources. Psychological first aid is recommended for management of acute stress, while psychological debriefing is discouraged. Further medical and psychiatric assessment and provision of brief, trauma-focused cognitive-behavioral therapy are warranted if clinically significant distress or functional impairment persists or worsens after 2 days or if the criteria for a diagnosis of acute stress disorder are met. Follow-up monitoring and rescreening are endorsed for at least 6 months for everyone who experiences significant acute posttraumatic stress. Four interventions that illustrate early intervention principles contained in the VA/DOD Clinical Practice Guideline are described.

Key words: acute stress disorder, acute stress response, clinical practice guideline, combat and operational stress response, crisis intervention, early intervention, military, psychological first aid, PTSD, veterans.


View HTML  ¦  View PDF  ¦  Contents Vol. 49, No. 5
This article and any supplementary material should be cited as follows:
Nash WP, Watson PJ. Review of VA/DOD Clinical Practice Guideline on management of acute stress and interventions to prevent posttraumatic stress disorder. J Rehabil Res Dev. 2012;49(5):637–48.
http://dx.doi.org/10.1682/JRRD.2011.10.0194

Last Reviewed or Updated  Wednesday, July 18, 2012 9:29 AM

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