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Acute Stress Disorder

Acute Stress Disorder develops within one month after an individual experiences or sees an event that involved a threat or actual death, serious injury or another kind of physical violation to the individual or others, AND responded to this event with strong feelings of fear, helplessness or horror. The diagnosis was established to identify those individuals who would eventually develop Post- 		 
  Traumatic Stress Disorder. While this is a relatively new diagnosis, for years this condition was referred to as "shell shock" and though it stems from reactions of soldiers as far back as the U. S. Civil War in 1865, civilians may also suffer from it. More recently, ASD was brought to light as it became clear that for a short period, people might exhibit PTSD-like symptoms immediately after a trauma (Morrison, 1995).

"Trauma" has both a medical and a psychiatric definition. Medically, "trauma" refers to a serious or critical bodily injury, wound, or shock. This definition is often associated with trauma medicine practiced in emergency rooms and represents a popular view of the term. Psychiatrically, "trauma" has assumed a different meaning and refers to an experience that is emotionally painful, distressful, or shocking, which often results in lasting mental and physical effects.

Psychiatric trauma, or emotional harm, is essentially a normal response to an extreme event. It involves the creation of emotional memories about the distressful event that are stored in structures deep within the brain. In general, it is believed that the more direct the exposure to the traumatic event, the higher the risk for emotional harm. Thus in a school shooting, for example, the student who is injured probably will be most severely affected emotionally; and the student who sees a classmate shot, even killed, is likely to be more emotionally affected than the student who was in another part of the school when the violence occurred. But even second-hand exposure to violence can be traumatic. For this reason, all children and adolescents exposed to violence or a disaster, even if only through graphic media reports, should be watched for signs of emotional distress.

Symptoms

For a diagnosis of Acute Stress Disorder, symptoms must persist for a minimum of two days to up to 4 weeks within a month of the trauma.

A person may be described as having Acute Stress Disorder if other mental disorders or medical conditions do not provide a better explanation for the person's symptoms. If symptoms persist after a month, the diagnosis becomes Post Traumatic Stress Disorder (Morrison, 1995).

Symptoms include:

  • Lack of emotional responsiveness, a sense of numbing or detachment
  • A reduced sense of surroundings
  • A sense of not being real
  • Depersonalization or a sense of being dissociated from self
  • An inability to remember parts of the trauma, "dissociative amnesia"
  • Increased state of anxiety and arousal such as a difficulty staying awake or falling asleep
  • Trouble experiencing pleasure
  • Repeatedly re-experiencing the event through recurring images and/or thoughts, dreams, illusions, flashbacks
  • Purposeful avoidance of exposure to thoughts, emotions, conversations, places or people that remind them of the trauma
  • Feelings of stress interfering with functioning; social and occupational skills are impaired affecting the patient's ability to function, pursue required tasks and seek treatment

 

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