International Society for Traumatic Stress Studies

President's Message

Posted 1 September 2008 in StressPoints by Stuart Turner, MD, MA, FRCP, FRCPsych

I would like to start my column this month by congratulating Paula Schnurr, PhD, past-President of ISTSS, who has received the third annual Ladies Home Journal "Health Breakthrough Award" for her work with PTSD and women veterans.  This is a well-deserved recognition of her outstanding achievement in our field and I am sure will be followed by other awards as her full contribution is acknowledged.
 
This is the time when we build up to the Annual Meeting, which will take place in Chicago from November 13 to 15 (with PMIs on November 12). I would like to thank Jane Herlihy as program chair for all her hard work, but also headquarters staff, program deputies, reviewers and advisers who have made this conference possible. I had no idea quite how much effort went into making this a successful meeting!
The conference theme this year is “Terror and its Aftermath” and many of the presentations reflect this, including sessions on the effects of terror on the military, on refugees and on children (including adult survivors).  The keynote speaker, Professor Cherif Bassiouni, JD, is a distinguished research professor of law at DePaul University College of Law, president emeritus of the International Human Rights Law Institute and a past nominee for a Nobel Peace Prize. He will set the scene, highlighting the importance of a legal and human rights framework for the understanding, prevention and relief of traumatic stress.  I am also delighted that Yael Danieli, PhD, will lead an invited panel of eminent speakers on the important subject of trauma and reparative justice. 
This year, we will also begin to address the topic of diagnosis and the revision process for DSM-V. One of the challenges we face as we move forward concerns the continuing diagnostic controversy that our field seems to attract. When I started to work with torture and then disaster survivors many years ago, the concept of PTSD was still new and under-recognized, especially in non-specialist services. Perhaps there is a tendency sometimes now for this diagnosis to be over-used (at least in the UK) in those same non-specialist services, for people who do not meet diagnostic criteria but who have suffered adversity of some sort. Diagnoses become more or less fashionable and either extreme carries its risks. 
However, if evidence of the utility of a diagnosis rests on its ability to stimulate basic and applied research, including the development of new and demonstrably successful interventions and clinical programs, then this has been an overwhelmingly successful diagnostic category. The next steps will take place in reviews and revisions of the DSM and ICD diagnostic systems. These are important not just for researchers and diagnosticians but for anyone engaged in forensic work, advocacy or whose program support rests on recognition of the needs of trauma survivors, including those with the full range of reactions to severe trauma.
There is an ongoing debate about how to describe traumatic stress reactions, other than PTSD. We have seen further work in ISTSS towards the development of a consensus guideline for complex reactions to trauma, led by Marylene Cloitre, PhD, Christine Courtois, PhD, and their colleagues in the ISTSS Complex Trauma Task Force. I strongly believe that this is an area of work that will come to attract greater attention in the years to come as we continue to develop new interventions for people with treatment-resistant and complex problems, going beyond PTSD.
This year, there will be a special track at the annual meeting in Chicago dedicated to a scientific discussion of trauma reactions in the context of the next DSM revision. There is a glittering array of invited speakers including no fewer than seven presidents of ISTSS, as well as the chair of the APA work group. The invited talks will be brief enough to allow ample opportunity for audience and panel discussion and we hope will help to set the scene for continuing dialogue in the 2009 annual meeting.
There are too many outstanding scientific presentations in the Annual Meeting itself for me to single them all out but I will mention the invited presentations by Rachel Yehuda and Joseph Zohar on the biology of PTSD, examining animal models of PTSD and their relevance to theory and treatment development. The quality of scientific discourse is, of course, always a strength of the ISTSS Annual Meeting and having had the opportunity of reading the abstracts, I can say with confidence that there will be fascinating scientific papers and symposia covering the whole field of traumatic stress.
We have two featured media presentations, by Kelly Kennedy and Tara Mckelvey, on the problems faced by soldiers at war but there is also a strong scientific and clinical track throughout the whole meeting related to the needs of serving soldiers and veterans. 
For those looking for more clinical topics, we have a record total of six master clinician sessions, covering such diverse topics as children (Alicia Lieberman), cognitive therapy (David Clark), refugees (Zachary Steel), EMDR (Roger Solomon), complex trauma (John Briere) and early responding (Richard Bryant). This is in addition to the workshops, case presentations and PMIs. I would draw attention to the three full-day PMIs – Judith Cohen and Anthony Mannarino presenting on trauma-focused CBT for children; Robyn Walser and Darrah Westrup presenting on Acceptance and Commitment Therapy; and Edna Foa and Elizabeth Hembree presenting on prolonged exposure (PE).
 
All in all, it promises to be an exciting meeting. I hope to see you there!