During the course of natural recovery, fearful feelings decrease over time and the individual regains his or her emotional and cognitive equilibrium. Perceived positive regard and early social support is shown to be important to successful recovery. In this review, we propose and gather evidence for what we term the social ecology of PTSD, a conceptual framework for understanding how both PTSD risk and recovery are highly dependent on social phenomena. There is no 'cookie cutter' treatment for every victim suffering with PTSD, as the disorder can manifest itself in many ways 8. In Part 2, we describe research linking social support as it occurs both before and after a trauma, and we note the consistency with which this social phenomenon is among the most powerful influences in both risk for and recovery from PTSD.
This study provides an example of the differing influences of social support: Attachment theory predicts that when an individual feels threatened, there will be an instinct to seek out safety in important relationships, whether these relationships are with the caregiver, as in the case of children, or within a selected social network, as in the case of adults. Such findings also suggest new methods to investigate the effects of social support on PTSD. In rodents, OT acts on the amygdala to reduce fear Amico et al. However, we believe that understanding at the neurobiological level how social information is processed and connected to states of fear, anxiety, safety, and reward will provide an important perspective on the social and psychological data reviewed above. The theory of attachment as developed by Bowlby , and Ainsworth et al. The specific effect of marital quality on the spousal handholding condition is consistent with attachment theory's prediction that specific attachment experiences influence the quality of emotional regulation provided by contact with attachment figures. Early variations in maternal care produce lifelong alterations in the HPA axis and stress response, and such models demonstrate how sensitivity to stress may be transmitted across generations through behavioral interactions. Abstract Retrospective and prospective studies consistently show that individuals exposed to human-generated traumatic events carry a higher risk of developing Posttraumatic Stress Disorder PTSD than those exposed to other kinds of events. Abstract Sexual assault occurs with alarming frequency in Canada. In a year prospective study of American Legionnaires whose combat exposure was in Vietnam, veterans with PTSD who showed more community involvement were more likely to show remission of their PTSD over the course of the study. In addition, the individual's subjective reaction must include but is not limited to the experience of fear, horror, and helplessness. A person's cognitions have a dramatic effect on the onset, severity, and progress of PTSD following sexual assault. Thus, subjective distress seems to be a useful variable and potent mediator or moderator of risk for PTSD. Psychological health is compromised following interpersonal trauma and many psychological therapies are available, but with varying efficacy. These studies suggest a pattern of co-occurrence of posttraumatic symptoms between an adult caregiver and a young child and the risk of subsequent exacerbation of the child's symptoms related to the symptom status of the adult caregiver. Sexual assault is any form of sexual contact without voluntary consent andthat violates a person's sense of autonomy, control and mastery over their body 2. In addition, for a given level of reported distress, women and men had similar odds of developing PTSD. At a cognitive level, positive social support may facilitate this process as it conveys the message that one is taken care of and is a member of a group whose task is in part the protection of its members. Social information appears to modulate very basic aspects of the fear system in humans, and positive social interactions can attenuate certain kinds of fear learning Olsson et al. We found that emotion regulation and social disturbances, so well documented among maltreated children, are also salient problems for adults with histories of childhood maltreatment. Sociological impacts of assault influence the development of PTSD through victim-blaming attitudes and the perpetuation of rape myths. In contrast, negative support may reinforce beliefs that the world is hostile, contributing to feelings of fear and lack of safety. For this reason, prospective studies or those from the military in which there is independent corroboration of trauma exposure e. These included avoidant behaviors in the parents with respect to the trauma as well as the child's perceived rejection by parents or feelings of guilt and anxiety caused by parents Deblinger et al.
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