Acute Stress Disorder

maftab92 By maftab92, 10th Jul 2010 | Follow this author | RSS Feed
Posted in Wikinut>Health>Mind & Spirit>Anxiety

According to DSM IV, Acute Stress Disorder is diagnosed when a person is exposed to a traumatic event. In that particular event the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.


In Acute Stress Disorder the person exhibits intense fear, helplessness, or horror. Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociative symptoms:
• a subjective sense of numbness, detachment, or absence of emotional responsiveness
• a reduction in awareness of his or her surroundings (e.g., "being in a daze")
• derealization
• depersonalization
• dissociative amnesia (i.e., inability to recall an important aspect of the trauma)
It is important to note that the traumatic event is persistently experienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or distress on exposure to reminders of the traumatic event.

It is also to realize that there will be a marked avoidance of stimuli that arouses recollections of the trauma (e.g., thoughts, feelings, conversations, activities, places or people).
Marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hyper vigilance, exaggerated startle response, motor restlessness) will be present too.

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual's ability to pursue some necessary activities or inability to assume responsibilities.

The disturbance lasts for a minimum of 2 days and a maximum of 4 weeks or occurs within 4 weeks of the traumatic event.

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Acute Stress Disorders is responsive to a wide variety of psychotherapies. These therapies typically emphasize cognitive and behavioral assessment and interventions. Cognitive Behavioral Therapies evaluatE apparent cause and effect relationships between thoughts, feelings, and behaviors, as well as implementing relatively straightforward strategies to lessen symptoms and reduce avoidant behavior.

A critical element of therapy is to increase exposure to the stimuli or situations that provoke anxiety. Without such therapeutic assistance, the sufferer typically withdraws from anxiety inducing situations, inadvertently reinforcing avoidant or escape behavior.

The patient is given reassurance that the feared situation is not deadly and a plan is introduces to enhance mastery. This plan may include approaching the feared situation in a graduated or stepwise hierarchy or teaching the patient to use responses that dampen anxiety, such as deep muscle relaxation or coping. This technique is also known as Systematic Desensitization.

Prolonged exposure to a feared stimulus reliably decreases cognitive and physiologic symptoms of anxiety. With such experiences generally come greater self-efficacy and a greater willingness to encounter other feared stimuli.

In a case of more severe and persistent symptoms, the patient may also require pharmacotherapy for short time.


Anxiety, Disorder, Health, Mental Health, Stress

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author avatar maftab92
I am a clinical psychologist from Pakistan. I am running my own clinic to help people overcome psychological problems.

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author avatar vpaulose
14th Jul 2010 (#)

very informative. congrats

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