Preface

Stress, as referred to in this book, means the experience of single or multiple events beyond what an average human being can withstand or bear. This form of stress is also known as traumatic stress. Such an event might entail actual or threatened death or severe injury or maiming of one's own body or the body of other individuals. Traumatic stress may also arise in response to viewing photographs of scenes of traumatic events. A considerable body of literature exists about traumatic stress, and it continues to grow as more and more research delves into the subject to provide additional understanding of the nature of human suffering because of exposure to traumatic incidents. This book discusses some of the current understanding of the disorders associated with traumatic stress. It includes eleven chapters.

In Chapter 1, Dr. Stewart Sherry provides a literature review of the current knowledge in the field. In Chapter 2, Dr. Baugh Lee et al. discuss the biomarkers that researchers and clinicians alike will need in dealing with the complex phenomenon of traumatic stress. The knowledge of biomarkers is likely to help researchers direct attention to further inquiries in future research. Likewise, information on biomarkers will help clinicians to carry out novel clinical investigations to enhance the rapid diagnosis and understanding of stress-related disorders. Of relevance of the knowledge of biomarkers is the potential use of biomarkers in decisions on what interventions will work in the short-term, medium-term, and long-term.

Using information from animal studies and postmortem data in Chapter 3, Dr. Shingo Enomoto and Takahiro A. Kato discuss the interesting and complex roles of microglia activation, proliferation, and neuro-inflammation in the genesis of mental disorders and pain in traumatic stress. In Chapter 4, Dr. Leena S. Bagadia and Arun More discuss the role of anger in the genesis and maintenance of hypertension. Along the same lines in Chapter 5, Tony McHugh and Glen Bates provide insight into the role of anger and imagery in the maintenance of stress-related disorders. In Chapter 6, Dr. Ghorbel et al. show how oxidative stress at the mitochondrial level might be involved in the etiology and maintenance of cardiovascular diseases.

In Chapter 7, Dr. Xaplanteri Panagiota provides compelling information against the practice of "mobbing" that medical residents experience during their training. Mobbing, which is a form of professional bullying in the training of students, is also used to make junior hospital staff feel belittled, ignorant, and inferior in the workplace. While mobbing might encourage learning, albeit, under uncomfortable circumstances, the practice makes healthcare providers resentful and vengeful toward other colleagues of lower rank.

Chapter 8 by Professor Tarhan Nevzat et al. provide a candid discussion of ontology and neurobiology as well as a variety of new diagnostic procedures in traumatic stresses from the adverse effects of childhood experiences (ACEs), genomics, epigenomics, and neuroimaging and positron emission computerised tomography (PECT). The chapter

also addresses the concept of "toxic stress" and cybercrimes as new and emerging forms of traumatic stress. Prof. Nevzat's discussion is particularly relevant given the rising tide of crimes committed online.

In Chapter 9, Jeannette C.G. Lely and Rolf J. Kleber discuss the problem of traumatic stress in later life. Individuals aged 70 years and older face a variety of challenges that people accept as normal processes of aging. People in this age group might have no jobs and incomes, might be lonely, might have a variety of somatic conditions (such as cancer, chronic pulmonary disorders, and cardiovascular disorders), and might suffer from dementia or depression in addition to the ever-present realization of their mortality. Under these conditions, traumatic stress disorders in later life deserve attention from every caregiver.

In Chapter 10, Dr. Mittal Swati et al. discuss the mental health impacts of the COVID-19 pandemic. Since the emergence of the pandemic, several thousand publications based on research and anecdotal observations have appeared in the scientific literature. The unique thing about COVID-19 is that it struck the world suddenly and many health experts did not quite know how to respond to it. The world has lost many lives either directly from the physical effects of the virus or the mental health complications of the pandemic. Dr. Swati's contribution to the mental health effects of the COVID-19 pandemic is therefore timely.

Finally, in Chapter 11, Professor Ovuga et al. provide data on the mental health wellness of lay counselors in situations of chronic and prolonged mass trauma. Professor Ovuga and his colleagues demonstrate from personal experience that lay counselors must be mentally sound to support their colleagues well.

> **Emilio Ovuga** Gulu University, Gulu, Uganda International Institute of Medicine and Science (IIMS), USA

Section 1

Current State of

Understanding

Section 1
