**10. References**

152 Post Traumatic Stress Disorders in a Global Context

Hobfoll's conservation of resources stress theory (Hobfoll, 1989; Chou et al., 2007), resource loss is an important determinant of individual stress and physical and mental health, including PTSD. Brewin et al. (2000) also found that the effect sizes of all risk factors were modest. Factors operating during or after the trauma (e.g., trauma severity, lack of social support, and additional life stress), however, had somewhat stronger effects than did pre-

Consequently, multiple risk factors constitute a network that results in psychiatric illness. According to Hobfoll's conservation of resources theory, resource loss is an important determinant of individual stress and physical and mental health, including PTSD. Our hypothesis states that an individual reaches a sub-threshold of psychiatric illness and then develops the illness due to a decreasing availability of resources, an accumulation of risk factors, and/or a major stressful event. Furthermore, unresolved, sub-clinical psychiatric symptoms caused by a disaster or major life event may increase a survivor's sensitivity to future stresses. When faced with stress, frustration (e.g., life events), or traumatic events (e.g., brain damage or deprivation of internal or external resources) individuals, either suddenly or gradually, become more vulnerable to psychiatric impairment and diseases such as PTSD. An individual might reach a sub-threshold of PTSD and then develop the illness due to a decreased availability of resources, an accumulation of risk factors (personality traits, poor social interactions, etc.) or a major stressful event. Furthermore, unresolved, subclinical psychiatric symptoms caused by a disaster may increase a survivor's sensitivity to future stresses. Other factors that tend to increase an individual's vulnerability to psychiatric problems include brain damage, heredity, personality traits, life events, and

Treatment or rehabilitation efforts should concentrate not only on severe psychiatric symptoms, emotional disturbances and personality traits or disorders, but also on interpersonal and social-environmental interactions. To treat PTSD, clinicians only use drugs and do not provide psychosocial treatment; thus, they cannot meet the true needs of the survivor. Based on the bio-psychosocial causation model of psychiatric disease as it applies to public health, we propose a model of the causation of PTSD. Issues related to PTSD that are most in need of further study include biological causation, psychosocial

Although changes in emotional, cognitive, behavioral, and biologic states are transitory for most individuals after a catastrophe or major trauma, psychological trauma may persist much longer in some victims. While the psychological profiles of these victims are often altered, given their vivid and repetitive recollection of the traumatic events (Chou et al., 2004b; Chou et al., 2005; Lin et al., 2002), Wang et al. (2000) determined that prompt and effective post-disaster intervention might mitigate the impact of initial exposure and reduce the probability of PTSD occurrence. Issues related to PTSD most in need of further study include biological causation, psychosocial recovery, and long-term evaluation of

trauma factors.

social interactions.

**9. Conclusion** 

psychological rehabilitation.

**8. The treatment and rehabilitation of PTSD** 

recovery, and long-term evaluation of psychological rehabilitation.


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**Part 3** 

**African Perspective** 

