A traumatic stress reaction is a normal reaction to the abnormal stressor events.
If that reaction continues for a period of at least one month, whether that reaction
occurs immediately after the event or at some point in the future, the reaction
becomes a post-traumatic stress disorder (PTSD) if the required number of symp-
toms is present. The primary components of the reaction are reexperiencing,
avoidance/withdrawal, and physiological arousal. Associated features of gen-
eralized anxiety, depression, grief, and guilt frequently coexist with the primary
symptoms.

Research studies have documented intrusive, avoidant, and physiological af-
tereffects of a variety of traumatic events ranging from childhood abuse to
exposure to the traumas of parents, to disasters, political torture, and survival
of homicides of significant others, to battering and assault, to participation in
war and combat, to duty-related trauma ( Kemp, Rawlings & Greene, 1991;
Schlenger et al., 1988; Walker, 1984; Williams, 1990).

The specific treatment of post-traumatic stress reactions and post-traumatic
stress disorder has evolved since its formalized inception as crisis intervention
and treatment of veterans after the Vietnam War. The recognition that individual
psychotherapy, family therapy, and group treatment of traumatic stress require
a specialized treatment paradigm, as well as techniques and approaches, has led
to the conceptualization of this book. It presents a compendium of specific
treatment approaches for event-related traumatized populations and examines the
relevance of specific methodologies for treatment of traumatized individuals
(e.g., hypnotherapy, drug therapy).

The book takes an interactive approach to treatment, recognizing that trau-
matized individuals do not live in isolation. Family and other social support is
particularly crucial in the healing process. In addition, treatment must focus on
emotional, cognitive, behavioral, interpersonal, biological, spiritual, and cultural
aspects of the reaction or disorder.

This book consists of nine parts describing generalized concerns and treatment
concepts, treatment for specific populations, techniques of treatment as they
apply to traumatized individuals, group treatment approaches, and needs/con-
cerns in the PTSD field. A description of each part follows.

Part I examines the theoretical, diagnostic, and practical aspects of treatment.
In Chapter 1, Wilson reviews and expands upon his 1989 interactive paradigm
of traumatic stress. He presents a holistic theoretical paradigm of person-envi-
ronment interactions. Chapter 2, by Litz and Weathers, describes methods to
collect diagnostic information concerning PTSD: clinical interview, question-
naire/inventory, and psychophysiological techniques. The authors offer guide-
lines for history taking, interview sequencing, and evaluation of associated
symptoms in adult survivors. Chapter 3, by Pearlman and McCann, discusses
structured and unstructured approaches to taking a trauma history as part of the

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