Acute Stress Reaction and Disorder

Acute Stress Reaction and Acute Stress Disorder

Clinical Picture

• Core symptoms include anxiety and depression, stemming from threatening experiences and feelings of loss, respectively.
• Anxiety and depression often co-occur due to the nature of stressful events combining danger and loss.
• Additional symptoms may include numbness, a dazed feeling, and memory difficulties.

Treatment

• Effective disaster response requires planning, training, and immediate psychological support for victims.
• Essential components of psychological first aid include comfort, protection from threat, immediate physical care, facilitating loved ones' reunion, sharing experiences, and identifying those needing further help.
• Debriefing involves discussing facts, thoughts, feelings, assessments, and education about stress management.
• Single-session debriefing may not alleviate psychological distress and can be counterproductive.

Management

• Support from friends or professionals is typical after traumatic events; medication may be prescribed for severe anxiety or sleep disturbances.
• Many stress reactions subside without intervention, but follow-up appointments around two weeks post-trauma can help identify those at risk for PTSD.
• Effective approaches for managing acute stress disorder include prolonged exposure therapy and trauma-focused cognitive behavioral therapy, outperforming general supportive counseling.

Acute Stress Disorder (ASD)

Definition and Symptoms

• ASD is a mental health disorder developing post-trauma, characterized by:
  • Dissociative symptoms: emotional numbness, detachment, reduced awareness, derealization, depersonalization, and dissociative amnesia.
  • Re-experiencing symptoms: intrusive memories, nightmares, or distressing reminders of the event.
  • Avoidance: steering clear of reminders of the traumatic experience.
  • Negative thoughts: emotional numbness, difficulty concentrating, and feelings of detachment.
  • Hyperarousal: increased alertness, exaggerated startle response, and sleep difficulties.

Diagnosis

• Diagnosed based on DSM-5 criteria, requiring marked anxiety, re-experiencing of the trauma, and evidence of distress symptoms post-trauma.
• ICD-10 categorizes ASD based on the presence of dissociative symptoms in varying severities from mild to severe.

Coping Strategies and Defense Mechanisms

• Coping mechanisms may include avoidance and denial, which provide temporary relief but can hinder recovery.
• "Working through" involves processing the traumatic event.

Variations in Clinical Presentation

• Non-adaptive coping strategies, such as substance use, can obstruct overall recovery efforts.
• Acute Stress Reaction (ICD-10) focuses on immediate psychological responses, while ASD (DSM-5) indicates a more significant clinical condition with potential progression to PTSD.

Epidemiology

• Prevalence rates of ASD vary significantly, ranging from 15% to 50% depending on the population and type of trauma experienced.
• Examples of trauma and associated ASD rates include:
  • Motor vehicle accidents: approximately 15% may develop ASD.
  • Sexual assaults: over 50% of women report experiencing ASD.
  • Natural disasters (e.g., Wenchuan earthquake): around 30% of survivors meet ASD criteria.

Aetiology

• Various traumatic events can trigger ASD, including personal trauma from accidents, assaults, natural disasters, or witnessing violence.

This quiz delves into the core symptoms of acute stress reactions and acute stress disorder, focusing on the interplay between anxiety and depression in response to stressful experiences. It examines how feelings of numbness, dazed perception, and difficulty coping are common following traumatic events. Test your understanding of these psychological responses and their implications.