Acute Stress Disorder

by Lilia GrenierPsychology

What is Acute Stress Disorder (ASD)?

ASD is an anxiety disorder characterized by a group of dissociative and anxiety symptoms that occur within a month of a traumatic event.

Traumatic events include: witnessing or experiencing rape or other violent assaults; death, suffered a severe injury or natural disaster, or a severe transport accidents.

The person's response involves intense fear, guiltiness, helplessness, or horror.

What are the differences between ASD and Post-Traumatic Stress Disorder?

ASD and PTSD are both disorders that can occur following a traumatic event.

ASD can be diagnosed between 2 days and 4 weeks after exposure, where PTSD can only be diagnosed after 4 weeks have passed.

In addition to the symptoms experienced in PTSD, ASD includes symptoms of dissociation.

If left untreated, ASD is likely to advance into PTSD.

Symptoms:

Dissociative symptoms Less aware of surroundings Feeling numb or detached Derealization Depersonalization Dissociative amnesia

Re-experiencing symptoms Dreams Illusions Flashback Intense distress

Other symptoms that indicate ASD

Sleeping problems Difficulty concentrating Irritability Inability to do necessary tasks including seeking help Feeling detached from others Motor restlessness Avoiding people or places that remind him/her about the event

Diagnosis

ASD is diagnosed by:

comparing the patient's symptoms to the DSM-IV and DSM-IV-TR criteria

using the Acute Stress Disorder Scale

Treatment of Acute Stress Disorder

Medications

Psychotherapy

Alternative and complementary treatments

Medications

Prescribed antidepressants: Sertraline Paroxetine Fluvoxamine Citalopram Clomipramine

For avoidance symptoms Fluoxetine

Medications

To reduce anxiety and panic Alprazolam Diazepam Clonazepam Lorazepam Propanol

For insomnia and nightmares Trazodone Topiramate

Psychotherapy

Cognitive-behavioral therapy Gestalt Therapy Psychoanalityc Rational-Emotive Therapy Behavior Therapy Group and Family Therapies Therapeutic Writing

Alternative and complementary treatments

Yoga Meditation Music Therapy Hypnosis Hydrotherapy Traditional Chinese Medicine Critical Incident Stress Management Program

Prognosis

80% of people diagnosed with ASD have PTSD six months later; 75% will develop symptoms of PTSD two years from the traumatic event.

Clinicians in Norway created a list of symptoms that appear to be an efficient prognosis of ASD's developing into PTSD: An exagerated startle response Fear or phobia affiliated to the location of the traumatic event The extent of patient's social withdrawal The severity of the patient's sleep disturbance

The effect of ASD on daily living

Physical well-being

Thoughts of suicide

Drug and alchool abuse

Isolation from family and friends

Difficulty functioning at work

Impact on the child’s school work

Symptoms and Diagnosis for children with ASD

Signs and symptoms include emotional numbing, social avoidance, sleep problems, school and play failure, delayed development.

Untreated acute stress in children develops into chronic PTSD, other serious psychiatric disorders, and/or developmental cardiac arrest complications.

The Child Stress Reaction Checklist (CSRC) is used by parents and the nurse to identify the symptoms of ASD.

The Child Post-Traumatic Stress Disorder Reaction Index is also used to measure ASD responses.

Treatment for children with ASD

Antidepressants:

Imipramine

Chloral hydrate

Cognitive Behavioral Therapy

Adjunctive Therapies

Family-Based Treatments

Group Therapy

References:

Jonker, Barbara,”Acute stress disorder in children related to violence.” Journal of Child adolescence Psychiatric Nursing. Apr.-Jan.2003.

25 Nov.2009. <http://findarticles.com/p/articles/mi_qa3892/is_200304/ai_n9197654/pg_5/?tag=content;col1>.

Tull, Matthew, “Acute Stress Disorder and PTSD.” About.com: Post Traumatic Stress (PTSD). 25 Nov.2009. <http://ptsd.about.com/od/causesanddevelopment/a/acutestress.htm>

Gibson, Laura E, “Acute Strees Disorder: A brief description.” Mental Health Matters. 26 Feb. 2009. 25 Nov.2009. <http://www.mental-health- matters.com/index.php?option=com_content&view=article&id=1218:acute-stress-disorder-a-brief-description&catid=44:acute-stress-disorder&Itemid=2045>.

“Acute stress disorder.” PsychNet-UK. 25 Nov.2009.

< http://www.psychnet-uk.com/dsm_iv/acute_stress_disorder.htm>.

Reference cont…

“Acute stress disorder.” Encyclopedia of Medical Disorders.

25 Nov.2009 . <http://www.minddisorders.com/A-Br/Acute-stress-disorder.html>.

“Definition of acute stress disorder.” MedicineNet.com-We bring doctors knowledge to you. 9 Feb. 2004 25 Nov.2009. <http://www.medterms.com/script/main/art.asp?articlekey=38856>

“Acute stress reaction.” Wikipedia, the free encyclopedia. 22 Nov.2009 25 Nov.2009

<http://en.wikipedia.org/wiki/Acute_stress_reaction>

Jackson, Henry M, “Guide to understanding Post-Traumatic Stress Disorder and Acute Stress Disorder.” Advancement of military medicine. 25 Nov.2009.

<http://www.virtualarmory.com/mobiledeploy/PDHRA/docs/W50258PTSD%20brochure.pdf>