Pre-medical psychological support in the educational environment: from neurobiology of stress to practical algorithms
DOI:
https://doi.org/10.32782/2077-6594/2026.3/06Keywords:
pre-medical assistance, teacher, stress, psychological supportAbstract
In wartime conditions, children and adolescents are continuously exposed to stressors such as air alerts, threats to life, and losses, which increase the risk of acute stress reactions and post-traumatic stress disorder (PTSD). Limited access to specialized medical and psychotherapeutic care emphasizes the role of educational institutions as environments for primary stabilization and the importance of teachers in providing initial support. Most teachers lack systematic training in pre-medical and psychological assistance during crisis situations. Under acute stress, a child’s ability to perceive and process complex information decreases, reducing the effectiveness of standard pedagogical approaches. Purpose is to develop and justify a systematic approach to teachers’ actions in acute psycho-emotional states of students, based on the neurobiological mechanisms of stress and the integration of physical and psychological support. Materials and Methods. Modern scientific literature and international recommendations of WHO on psychological first aid were analyzed. Neurobiological mechanisms involving the amygdala, prefrontal cortex, and sympathetic nervous system were reviewed. Results. Practical algorithms were systematized for primary assessment, acute stress reactions, panic attacks, stupor, psychomotor agitation, and identification of “red flags” requiring medical intervention. The role of coping strategies was also analyzed. Conclusions. Educational institutions are important settings for early stabilization of psycho-emotional states. Simple, structured algorithms may reduce distress, prevent complications, and support the development of coping skills and psychological resilience.
References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). 5th ed. Washington, DC: APA; 2022. DOI: https://doi.org/10.1176/appi.books.9780890425787.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: American Psychiatric Publishing; 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596.
Pynoos RS, Steinberg AM. Traumatic stress in children and adolescents. Psychiatr Clin North Am. 2014;37(1):1–14. DOI: https://doi.org/10.1016/j.psc.2013.11.006.
Khamis V. Coping with war trauma and psychological distress among schoolage Palestinian children. American Journal of Orthopsychiatry. 2015;85(1):72–79. DOI: https://doi.org/10.1037/ort0000039.
National Child Traumatic Stress Network. Psychological First Aid for Schools. Los Angeles: NCTSN; 2012.
World Health Organization. Psychological first aid: Guide for field workers. Geneva: WHO; 2011.
Inter-Agency Standing Committee. Guidelines on Mental Health and Psychosocial Support in Emergency Settings. Geneva: IASC; 2007.
OECD. Safe and Supportive Learning Environments. Paris: OECD; 2017.
LeDoux JE. Emotion circuits in the brain. Annu Rev Neurosci. 2000;23:155–184. DOI: https://doi.org/10.1146/annurev.neuro.23.1.155.
Isenberg N, Silbersweig D, Engelien A, Holmes S, Bummorigg K, MacIntosh J, et al. Linguistic threat activates the human amygdala. Proc Natl Acad Sci USA. 1999;96(18):10456–10459. DOI: https://doi.org/10.1073/pnas.96.18.10456.
McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338(3):171–179. DOI: https://doi.org/10.1056/NEJM199801153380307.
Arnsten AFT. Stress signalling pathways that impair prefrontal cortex structure and function. Nat Rev Neurosci. 2009;10(6):410–422. DOI: https://doi.org/10.1038/nrn2648.
Sapolsky RM. Why zebras don’t get ulcers. New York: Holt; 2004.
Levine PA. In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books; 2010. 15. WHO, UNICEF. Doing What Matters in Times of Stress. Geneva: WHO; 2020.
Cheng C, Lau HPB, Chan MPS. Coping flexibility and psychological adjustment to stressful life changes: A meta-analytic review. Psychological Bulletin. 2014;140(6):1582–1607. DOI: https://doi.org/10.1037/a0037913.
Shonkoff JP, Garner AS. The lifelong effects of early childhood adversity. Pediatrics. 2012;129(1):e232–e246. DOI: https://doi.org/10.1542/peds.2011-2663.
Osaka M, Yaoi K, Minamoto T, Osaka N. When do negative and positive emotions modulate working memory performance? Sci Rep. 2013;3:1375. DOI: https://doi.org/10.1038/srep01375.
Shapiro E, Laub B, Rozenblat O. Early EMDR Intervention following intense rocket attacks on a town: a randomised clinical trial. Clinical Neuropsychiatry. 2018;15(3):194–205.
NCT03496714. Online psychoeducation for the prevention of PTSD. URL: clinicaltrials.gov/show/NCT03496714 (first received 12 April 2018).
Fine NB, Achituv M, Etkin A, Merin O, Shalev AY. Evaluating web-based cognitive-affective remediation in recent trauma survivors: study rationale and protocol. European Journal of Psychotraumatology. 2018;9(1):1442602. DOI: https://doi.org/10.1080/20008198.2018.1442602.




