The nosological roots of post-traumatic stress disorder (PTSD) may be traced back to th American Psychiatric Association's DSM-I entry of gross stress reaction, as published in 1952. Yet the origins of the current enthusi asm with regard to post-traumatic stress can be traced back to 1980, which marked the emergence of the term post-traumatic stress disorder in the DSM III. This reflected the American Psychiatric Association's acknowledgment of post-traumatic stress as a discrete, phenomenologically unique, and reli able psychopathological entity at a time in American history when such recognition had important social, political, and psychiatric implications. Clearly, prior to DSM-I the lack of a generally accepted terminology did little to augment the disabling effects that psychological traumatization could engender. Nor did the subsequent provision of an official diagnostic label alone render substantial ameliorative qualities. Nevertheless, the post Vietnam DSM-III recognition of PTSD did herald a dramatic increase in research and clinical discovery. The American Red Cross acknowledged the need to establish disaster mental health services, the American Psychological Association urged its members to form disaster mental health networks, and the Veterans Administration established a national study center for PTSD."

This comprehensive update of the now classic text applies the most current findings across disciplines to the treatment of pathogenic human stress arousal. New and revised chapters bring together the art and science of intervention, based in up-to-date neuroscience, starting with an innovative model tracing the stress-to-disease continuum throughout the systems of the human body. The authors detail the spectrum of physiological and psychological treatments for the stress response, including cognitive therapy, neuromuscular relaxation, breathing exercises, nutritional interventions, and pharmacotherapy. They also assess the strengths and limitations of widely-used measures of the stress response and consider the value of personality factors, cultural considerations, and resilience in stress mediation. Included in the coverage: The anatomy and physiology of the human stress response. Advances in neuroscience: implications for stress. Crisis intervention and psychological first aid. Neurophysiological rationale for the use of the relaxation response. Physical exercise and the human stress response. The pharmacological management of stress reactions. Disaster Mental Health Planning. Cultural Awareness and Stress. The Fourth Edition of A Clinical Guide to the Treatment of Human Stress Response offers readers a dual perspective, exceedingly useful in examining the origins of the stress response, and in preventing and treating the response itself. This rich integrative volume will join its predecessors in popularity among practitioners and students across disciplines and specialties.

This new edition emphasizes the unique contribution of this longstanding text in the integration of mind/body relationships. The concept of stress, as defined and elaborated in Chapter 1, the primary efferent biological mechanisms of the human stress response, as described in Chapter 2, and the link from stress arousal to disease, as defined in Chapter 3, essentially remains the same. However, updates in microanatomy, biochemistry and tomography are added to these chapters. All other chapters will be updated as well, as there has been significant changes in the field over the past eight years.

Barely more than twenty years ago the inquiry into the nature and implications of the psychophysiologic stress response seemed to be restricted to laboratory animals. Today, however, scientists from a wide range of disciplines are studying stress and its implications for human health and disease. This may be because our technical ability actually to measure the phenomenon has increased, as has our understanding of human psychophysiology. Just as important, how ever, may be the fact that we have entered a new era of disease. According to Kenneth Pelletier, we have entered upon an era in which stress plays a dominant role in the determination of human disease. Pelletier has stated that up to 90% of all disease may be stress-related. Whether this estimation seems inflated or not, the fact remains that clinicians of all kinds, including physicians, psychologists, physical therapists, social workers, and counselors, are daily being confronted with clients suffering from excessive psychophysiologic stress arousal. This fact has created a need to know more about the stress response and its treatment. Although more and more health-care professionals are directly or indirectly working with clients who manifest excessive stress, there has been no text previously written which attempted to condensE' between the covers of a single volume a practical, clinically compre hensive discussion of what stress is (as best we currently understand it) and how to treat it when it becomes excessive."