Everyone who has ever experienced stress, or wondered about the effects of stress on their minds and bodies, will benefit from the insights in this clearly written and accessible book.
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J. Douglas Bremner, M.D., is Associate Professor of Psychiatry and Radiology and Director of the Emory Center for Positron Emission Tomography at Emory University School of Medicine in Atlanta, Georgia, and Director of Mental Health Research at the Atlanta VAMC in Decatur, Georgia. He has authored over 150 publications, and written or edited three books, most recently Does Stress Damage the Brain? Understanding Trauma-Related Disorders from a Mind-Body Perspective.
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.
Copyright 2002 Reed Business Information, Inc.
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 Reed Business Information, Inc.
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