Traumatic stress disorders: A classification with implications for prevention and management

The management and prevention of acute and post-traumatic stress disorders are current themes of great importance to the defense health services of ma ny nations. Currently, between 2% and 8% of service members deployed on com bat operations, United Nations peacekeeping tasks, and humanitarian and dis aster relief operations present with one or more stress disorders within 3 years of deployment. The management of acute stress disorders and the preve ntion and management of post-traumatic stress disorders necessitate an unde rstanding of the nosology of this group of illnesses. Research into some pr eventive options-such as critical incident stress debriefing-also necessita tes the selection of syndrome-specific subjects during case finding if cont roversies about the efficacy of such interventions are to be resolved. Diag nostic features, a summary of the nosological evolution, and key points of differential treatment options are presented for 5 acute operational stress disorders (acute combat stress disorder, conversion reactions, the counter -disaster syndrome, peacekeeper's acute stress syndrome, and the Stockholm syndrome) and for 11 post-traumatic disorders, including classic post-traum atic stress disorder, chronic fatigue syndrome, Gulf War syndrome, peacekee per's stress syndrome, survivor's guilt syndrome, and the syndrome of Lifes tyle and cultural change.