The answer to the title is yes, according to Bremner, the director of Emory University's Center for Positron Emission Tomography, an associate professor of psychiatry and radiology at Emory's school of medicine and the editor of two textbooks on trauma. In this general introduction to the psychology of post traumatic stress disorder, or PTSD, Bremner's central thesis is that various discrete diagnoses for trauma-related illnesses can be unified: "patients exposed to different types of trauma have more in common than they have differences." Bremner sees the damage of trauma as being inflicted chiefly to the hippocampus, the part of the brain that stores memory, and his book is most articulate on this subject. His lab work on dissociation in Vietnam veterans and studies of sexually abused women are grimly cogent. The tone is relaxed and avuncular, to the point where the book sometimes meanders, as when Bremner gives the history of radiation or a discourse on gun-control laws. There is also the occasional sentence that may flummox the lay reader: "Stress results in an inhibition of neurogenesis in the dentate gyrus... an effect mediated by the NMDA receptor...." Too specialized for a general audience, yet not well-organized enough for specialists, this book may not get the audience demanded by some of its insights. (Sept. 15) Copyright 2002 Cahners Business Information.
The stress response, paradoxically, can both ensure our immediate survival and threaten long-term physical and mental well-being. These titles describe the mechanisms involved in responding to stress, but they take different tacks. Bremner (psychiatry and radiology, Emory Univ. Sch. of Medicine) focuses on traumatic stress-its effects on individuals and their ability to work and to relate to others. His premise is that "stress-induced brain damage underlies and is responsible for the development of a spectrum of trauma-related psychiatric disorders." Bremner offers a persuasive argument for revising the current diagnostic schema of the Diagnostic and Statistical Manual IV (which currently classifies numerous trauma as distinct conditions) to provide for one single spectrum of disorders, including both acute and chronic posttraumatic stress disorder and related conditions. Like McEwen, Bremner details the biological mechanisms of the stress response, focusing especially on the changes that occur within the brain. The author also touches briefly on Freudian psychotherapy, the use of medical scanning devices, the nature vs. nurture argument, the validity of delayed recall, etc. Despite some occasional repetitive and awkward constructions in his text, Bremner offers an interesting and valuable perspective on the subject of traumatic stress. His book will particularly interest professionals. McEwen (head, Neuroendocrinology Laboratory, Rockefeller Univ.) uses the term allostasis to denote the stress response in which maximum energy is delivered to those parts of the body that will be critical for self-protection. Allostatic load, on the other hand, describes a system that turns against itself. McEwen discusses in detail the processes by which stress affects the cardiovascular and immune systems as well as the brain. The brain, according to McEwen, can be "the target as well as the initiator of the stress response." This system, however, need not inevitably threaten us. Lifestyle changes, including proper diet, exercise, rest, and the development of positive coping skills, can make an enormous difference in our ability to minimize the effects of chronic stress. McEwen's book is skillfully written and will appeal to a wide readership.-Laurie Bartolini, Illinois State Lib., Springfield Copyright 2002 Cahners Business Information.
"Timely, intelligent and clinically accurate. Bremner clearly describes the hidden knowledge that stress hurts the brain and body. And more-he offers the reader important solutions."
"Dr. Bremner has written an exceptionally interesting and useful book. In lieu of focusing on a single avenue of stress-related psychopathology, Dr. Bremner cogently recognizes that trauma spectrum disorders (PTSD, dissociation, depression, anxiety, and borderline personality) share common brain abnormalities and overlapping psychiatric symptoms. The chapters are well written and provide significant information regarding the history, epidemiology, etiology, and treatment of stress-related disorders. This is a state-of-the-art work that will serve as an outstanding reference for practitioners and researchers."
"Never before has the impact of stress and trauma experiences on the functioning and structure of the brain been so clearly and convincingly demonstrated as in this book by J. Douglas Bremner. This book is characterized by clear-headed thinking, careful analysis, and sound research, and also has important implications for the therapeutic management of trauma patients. It will therefore become a historical landmark in the trauma field and is a 'must read' for all clinicians, researchers, and mental health workers."
"A clearly written book on the topic of neurobiology of stress.offers creative solutions to treatment of stress-related disorders."
Jennifer J. Jasterling Neurology
"Posttraumatic stress disorder is among the most common and disabling of all neuropsychiatric disorders. In recent years, research conducted by J. Douglas Bremner has identified substantial effects of psychological stress on brain structure and function. This work has led to a revolution in thinking on how to conceptualize PTSD and, most importantly, to discover new treatment approaches. This book eloquently describes these advances and the clinical implications for all people exposed to severe stress."
"[...] The benefit of [this book] (perhaps more for clinicians and educated laypersons than for neuroscientists) is in the integration of well-known biological evidence from a 'mind-body' perspective."
Nature - Thomas Elbert and Brigitte Rockstroh
"A clearly written book on the topic of neurobiology of stress.offers creative solutions to treatment of stress-related disorders."
The Lancet Neurology - Jennifer J. Jasterling
