Richard Allan Bryant AC FAA (born 17 August 1960) is an Australian medical scientist. He is Scientia Professor of Psychology at the University of New South Wales (UNSW) and director of the UNSW Traumatic Stress Clinic, based at UNSW and Westmead Institute for Medical Research. [1] His main areas of research are posttraumatic stress disorder (PTSD) and prolonged grief disorder. On 13 June 2016 he was appointed a Companion of the Order of Australia (AC), for eminent service to medical research in the field of psychotraumatology, as a psychologist and author, to the study of Indigenous mental health, as an advisor to a range of government and international organisations, and to professional societies. [1] [2] [3]
After attending North Sydney Boys High School, Bryant completed his B.A. (Hons) in Psychology at the University of Sydney in 1983; his Master of Clinical Psychology at Macquarie University in 1986; and his Doctor of Philosophy in Psychology at Macquarie University in 1989. [4] He was awarded a Doctor of Science at the University of New South Wales in 2016. He is a Fellow of the Australian Psychological Society, Fellow of the Association for Psychological Science, Fellow of the Australian Academy of Science, Fellow of the Australian Academy of Health and Medical Sciences, Fellow of the Academy of the Social Sciences in Australia. [5]
In 1989 Bryant commenced working at Westmead Hospital as a clinical psychologist, responsible for managing trauma and burns patients. In 1993 he established the Traumatic Stress Clinic at Westmead Hospital. In 1995 he joined the School of Psychology at the University of New South Wales as a Lecturer, and was promoted to Professor in 2002. Bryant was appointed a Scientia Professor in 2005. [4] In 2009 he was awarded an inaugural Australian Research Council Laureate Fellowship, and in 2014 a National Health and Medical Research Council Senior Principal Research Fellowship. [6]
Bryant has worked on many Australian and international projects aimed at reducing PTSD and other mental health disorders following trauma exposure. [7] These include the 9/11 terrorist attacks in New York, the 2004 Asian tsunami, and Hurricane Katrina. For example, he worked with the Thai Ministry of Health to develop a mental health initiative to manage the effects of the tsunami on mental health. [5] Following Hurricane Katrina he was invited to co-develop a mental health protocol for managing disasters in the USA. [8] Bryant adapted his protocol in the aftermath of the major Black Saturday bushfires in Australia, which government authorities adopted as the mental health response to the disaster. [9] In addition, he served on the American Psychiatric Association's DSM-5 Working Group on Traumatic Stress Disorders and the World Health Organisation's ICD-11 Traumatic Stress Advisory Group to develop the new diagnostic definitions of traumatic stress disorders. [10] [11]
Bryant's Traumatic Stress Clinic, founded in 1993, is a major not-for-profit treatment centre. It has conducted many research activities pertaining to the development, maintenance, and treatment of traumatic stress. It conducts treatment programs for PTSD, Prolonged Grief Disorder, PTSD in emergency service workers (police, fire, and ambulance workers), and PTSD in journalists. [12]
Acute stress disorder was a new disorder introduced in 1994 to describe acute traumatic stress in the initial month after trauma that is predictive of chronic PTSD. [13] Bryant is widely recognised as the world's leading expert on acute stress disorder. [8] On the basis of numerous longitudinal research, he has developed the prevailing measurement tools of acute stress disorder, identified many of the biological, cognitive, and behavioural indices of acute stress, and pioneered the major treatment studies of acute stress disorder. His assessment instruments have been translated into over 15 languages, and his treatment protocols are the gold standard for early intervention after trauma. [11]
When acute stress disorder was introduced it was argued that its emphasis on dissociative symptoms in the acute phase after trauma (such as emotional numbing, dissociative amnesia, and depersonalisation) are strongly predictive of chronic PTSD. Bryant's work challenged the fundamental premise of the initial conceptualisation that dissociative responses shortly after trauma are seminal in predicting PTSD, and this resulted in a major shift in the DSM-5 so that emphasis was not placed on dissociation and acute stress disorder was not intended to predict PTSD.
Bryant has conducted numerous treatment trials on Post-traumatic stress disorder with a focus on cognitive behaviour therapy. [7] In terms of treatment of PTSD, he has also conducted the first studies that showed genetic markers of treatment response, brain regions using functional MRI and structural MRI to predict treatment response, and how cognitive behaviour therapy alters brain function in PTSD patients. He has also conducted seminal studies on the development of PTSD by assessing people prior to trauma and subsequent to the trauma; these studies have mapped core psychophysiological and cognitive risk factors for developing PTSD. [2] [14]
Bryant has conducted some of the first studies into cognitive factors that underpin Prolonged Grief Disorder from normal bereavement, including memory styles, appraisals, and how people imagine their futures. Bryant has also conducted the first studies of different neural circuits between Prolonged Grief Disorder and other psychological conditions. [15] In addition, he conducted a major controlled trial of treating Prolonged Grief Disorder that demonstrated that reliving memories of the loss is critical to optimising treatment response.
Bryant has collaborated with the World Health Organisation to develop a mental health intervention that can be trained to lay health providers in countries that lack mental health specialists. [1] [9] The intervention (termed Problem Management Plus) has been developed to ensure that Low and Middle Income Countries can scale up the intervention to reduce mental health problems following adversity. [2]
Neurosis is a term mainly used today by followers of Freudian thinking to describe mental disorders caused by past anxiety, often that has been repressed. In recent history, the term has been used to refer to anxiety-related conditions more generally.
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences, such as experiencing violence, rape, or a terrorist attack. The event must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se.
Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that is controversial within the psychological community. It was devised by Francine Shapiro in 1987 and originally designed to alleviate the distress associated with traumatic memories such as post-traumatic stress disorder (PTSD).
Acute stress disorder is a psychological response to a terrifying, traumatic or surprising experience. It may bring about delayed stress reactions if not correctly addressed. Acute stress may present in reactions which include but are not limited to: intrusive or dissociative symptoms, and reactivity symptoms such as avoidance or arousal. Reactions may be exhibited for days or weeks after the traumatic event.
Complex post-traumatic stress disorder (CPTSD) is a stress-related mental disorder generally occurring in response to complex traumas, i.e. commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.
Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.
Grief counseling is a form of psychotherapy that aims to help people cope with the physical, emotional, social, spiritual, and cognitive responses to loss. These experiences are commonly thought to be brought on by a loved person's death, but may more broadly be understood as shaped by any significant life-altering loss.
Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.
Memory and trauma is the deleterious effects that physical or psychological trauma has on memory.
Yuval Neria is a Professor of Medical Psychology at the Departments of Psychiatry and Epidemiology at Columbia University Medical Center (CUMC), and Director of Trauma and PTSD Program, and a Research Scientist at the New York State Psychiatric Institute (NYSPI) and Columbia University Department of Psychiatry. He is a recipient of the Medal of Valor, Israel's highest decoration, for his exploits during the 1973 Yom Kippur War.
PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.
Childbirth-related post-traumatic stress disorder is a psychological disorder that can develop in women who have recently given birth. This disorder can also affect men or partners who have observed a difficult birth. Its symptoms are not distinct from post-traumatic stress disorder (PTSD). It may also be called post-traumatic stress disorder following childbirth (PTSD-FC).
Richard McNally is an American psychologist and director of clinical training at Harvard University's department of psychology. As a clinical psychologist and experimental psycho-pathologist, McNally studies anxiety disorders and related syndromes, such as post-traumatic stress disorder, obsessive–compulsive disorder, and complicated grief.
Trauma focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychotherapy or counselling that aims at addressing the needs of children and adolescents with post traumatic stress disorder (PTSD) and other difficulties related to traumatic life events. This treatment was developed and proposed by Drs. Anthony Mannarino, Judith Cohen, and Esther Deblinger in 2006. The goal of TF-CBT is to provide psychoeducation to both the child and non-offending caregivers, then help them identify, cope, and re-regulate maladaptive emotions, thoughts, and behaviors. Research has shown TF-CBT to be effective in treating childhood PTSD and with children who have experienced or witnessed traumatic events, including but not limited to physical or sexual victimization, child maltreatment, domestic violence, community violence, accidents, natural disasters, and war. More recently, TF-CBT has been applied to and found effective in treating complex posttraumatic stress disorder.
Posttraumatic stress disorder (PTSD) is a cognitive disorder, which may occur after a traumatic event. It is a psychiatric disorder, which may occur across athletes at all levels of sport participation.
Internet interventions for post-traumatic stress have grown in popularity due to the limits that many patients face in their ability to seek therapy to treat their symptoms. These limits include lack of resources and residing in small towns or in the countryside. These patients may find it difficult to seek treatment because they do not have geographical access to treatment, and this can also limit the time they have to seek help. Additionally, those who live in rural areas may experience more stigma related to mental health issues. Internet interventions can increase the possibility that those who suffer from PTSD can seek help by eliminating these barriers to treatment.
Andreas Maercker is a German clinical psychologist and international expert in traumatic stress-related mental disorders who works in Switzerland. He also contributed to lifespan and sociocultural aspects of trauma sequelae, e.g. the Janus-Face model of posttraumatic growth. Recently, he has been increasingly engaged in cultural clinical psychology.
Trauma in first responders refers to the psychological trauma experienced by first responders, such as police officers, firefighters, and paramedics, often as a result of events experienced in their line of work. The nature of a first responder's occupation continuously puts them in harm's way and regularly exposes them to traumatic situations, such as people who have been harmed, injured, or killed.
Psychological trauma in adultswho are older, is the overall prevalence and occurrence of trauma symptoms within the older adult population.. This should not be confused with geriatric trauma. Although there is a 90% likelihood of an older adult experiencing a traumatic event, there is a lack of research on trauma in older adult populations. This makes research trends on the complex interaction between traumatic symptom presentation and considerations specifically related to the older adult population difficult to pinpoint. This article reviews the existing literature and briefly introduces various ways, apart from the occurrence of elder abuse, that psychological trauma impacts the older adult population.