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This chapter focuses primarily on persons exposed to intentional human violence occurring on a mass scale, although, with modification, the principles outlined may be applicable to other trauma-affected populations. Concerns are raised that careers and livelihoods have been built on the posttraumatic stress disorder (PTSD) industry, and that the priority of trauma debriefing and counselling has been oversold to aid agencies and other donor organizations. The five domains of stress and their adaptive systems are hypothetical constructs that are considered to subsume the functions of safety, attachment, identity and role, justice, and existential meaning. The model proposed aims to encourage a process of abstraction in which crude trauma events are organized according to their psychosocial meanings and their consequent impact on adaptation. The chapter discusses the implications that may arise for acute interventions linked to the adaptive domains.
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