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Resilience and Vulnerability to Trauma 363strate and human experience will hopefully lead to improvements in the pharmacologicaltreatment of trauma survivors. At present, medications such as antidepressants,anxiolytics and anticonvulsants, originally developed for otherdisorders, are currently being tested and used with some success in the treatmentof PTSD (reviewed in Friedman, 2000). Antidepressants, including MAOIs,tricyclics, and SSRIs are considered effective pharmacotherapeutic treatmentsfor PTSD. Among these drug classes, SSRIs such as Prozac, Paxil, and Zoloftare considered first-line agents for PTSD (reviewed in Albucher & Liberzon,2002), though no particular SSRI has emerged the clear leader. Medication isparticularly helpful in reducing distressing PTSD symptoms, associated depression,and functional impairments and disabilities (reviewed in Stein et al.,2006); thus medication may facilitate participation in psychotherapy. In addition,rats pretreated (treatment before exposure to a stressor, e.g., forced swimtest) with a benzodiazepine or tricyclic antidepressant did not develop learnedhelplessness (Petty et al., 1992, 1997). Thus, it is possible that medication priorto trauma could increase resilience or raise the threshold for development ofpsychopathology.Recent findings on the neurobiological correlates of PTSD have generated newinterest in mechanisms that may have implications for PTSD and other stressrelatedillnesses. At this time, PTSD-specific drug trials are underway to evaluatethe efficacy of new compounds that may have an impact on the unique pathophysiologyof PTSD. Some of these include NPY enhancers, substance P antagonists,NMDA agonists, antiadrenergics, and compounds that downregulate glucocorticoidreceptors (reviewed in Friedman, 2000). In addition, recent data suggest thatD-cycloserine, an NMDA receptor partial agonist (widely available and safe) maybe used in conjunction with exposure therapy to facilitate the acquisition of newlearning, accelerate the formation of new associations, and thereby reduce symptomsof conditioned fear. In a study evaluating the combination of D-cycloserineand exposure therapy in acrophobic patients, the treatment was effective in significantlyreducing symptoms of fear and anxiety (Ressler et al., 2004). This combinationmay hold promise for the treatment of PTSD, though no conclusive studies haveascertained this yet.A coordinated approach is essential in any endeavor to promote resilience.Bolstering one resilience factor will have additive properties and synergistic effectson overall well-being. Considerations such as a healthy lifestyle (diet, exercise),social support, religion/spirituality, community membership, self-help/bibliotherapy, alternative healing practices, and psychotherapeutic or psychopharmacologicinterventions are all of interest in creating a resilient psychologicalresponse to trauma. Furthermore, a deeper understanding of the complicated dynamicsof genetics, biological substrate, and human experience of trauma willilluminate the future of psychiatric and psychological intervention.