 Acute Care Early Intervention in the Emergency DepartmentBarbara O. Rothbaum, Ph.D., ABPP |
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| Who: | End users: Patients presenting to the Emergency Room following a psychologically traumatic event Direct recipients: All adult patients at Grady Memorial Hospital aged 21-65 who present to the ED following exposure to a traumatic event according to DSM-IV diagnostic criterion A (e.g., automobile accident, sexual or physical assault, industrial disaster) within 72 hours during enrollment times will be eligible to participate. |
| What: | 75 individuals presenting at the ED will be randomly assigned to one of the 2 conditions: 1) ‘Immediate Treatment’ Group: which includes immediate prolonged exposure therapy (PE) in ED plus delayed PE (3 sessions total); or 2) ‘Assessment only’ group, which includes evaluation in the ED and 4 and 12 weeks post-trauma. Eligible individuals will have undergone an experience that would meet criterion A of the DSM and not have lost consciousness due to injury or head trauma and have a memory for what happened. We will examine predictors for response including sociological, neurochemical, and psychological predictors in the ED, and at 4 and 12 weeks. |
| Where: | Grady Memorial Hospital Emergency Department (ED), Atlanta, GA |
| Why: | There currently are no accepted interventions for the early intervention and prevention of post-traumatic stress disorder (PTSD) in the immediate aftermath of trauma. The initial symptoms of PTSD can be considered part of the normal reaction to trauma, but those who suffer from chronic PTSD do not recover in the weeks and months following a trauma the way others do. Therefore, PTSD can be viewed as a failure of recovery caused in part by a failure of fear extinction following trauma. |
| Impact: | The overall aim of this project is to gather pilot data to begin to determine if exposure therapy in the immediate aftermath of trauma can prevent the development of PTSD. The long term goals are to establish pharmacological and psychotherapeutic interventions in the immediate aftermath of trauma to reduce the likelihood of developing a durable fear response such as PTSD for those at risk. |
| Return on Investment: | Both civilian and combat PTSD are common and debilitating, and estimates range between 37%-92% of individuals will be exposed to severe trauma during their lifetime. If the psychological impact of these events can be reduced, preserving or restoring pre-trauma levels of functioning, the savings in terms of human suffering and economic impact could be huge. |