Acute Stress Disorder

Nature

Acute Stress Disorder (ASD) is diagnosed following the direct or indirect exposure of a traumatic event.

The key feature is the development of symptoms that appear as early as three days to one month following the traumatic event. Individuals with Acute Stress Disorder will often engage in catastrophic and negative thoughts regarding their role and response to the traumatic event.

Experience

Individuals with ASD experience dissociative symptoms or feelings of detachment; this is what makes ASD different from PTSD.

People with ASD may feel emotionally detached from their lives and emotionally numb. The world may seem unreal.  Dissociation can last a few seconds, hours, or even days. During the dissociation, the individual relives the event and may behave in a manner as if they were experiencing the event in that moment. Some patients also experience dissociative amnesia, which makes recalling precise details of the traumatic event difficult. Detachment has been described by some as akin to seeing oneself from the other side of the room or having a distorted view of their surroundings.  

Anger, aggressive responses, and irritability can also be a common response. The individual may re-experience the traumatic event through intrusive spontaneous or recurring memories. The intrusive memories are often triggered by sensory, emotional, or physiological experiences which leads to avoidance of these triggering experiences. Distressing dreams related to the trauma are commonly experienced, as well as panic attacks, sleep difficulties, and impulsive behaviors.

Impact

Individuals exposed to a traumatic event, whether directly or indirectly, often experience impairment in academic, social, functional, and interpersonal aspects of their lives.

Depending on the extent of anxiety, the individual can experience trouble with sleep and energy levels, which can interfere with performing daily living activities. Due to the anxiety, the individual may start to avoid situations that make them feel distressed or remind them of the trauma, resulting in withdrawal from situations or scenarios they perceive to be potentially dangerous including doctor appointments, school, work related obligations, and other life responsibilities.

Prevalence of Acute Stress Disorder

Acute stress disorder occurs in 20-50% of victims or witness of trauma involving interpersonal assault. Less than 20% of victims or witnesses of trauma without interpersonal assault (ex. motor vehicle accidents, severe, burns) experience Acute Stress Disorder.

Treatment

Traditional Cognitive Behavioral Therapy (CBT) is a treatment protocol utilized to reduce trauma related symptoms.

Through cognitive restructuring, the individual identifies and challenges irrational and unhelpful thought patterns. In addition to traditional CBT, Exposure Response Prevention (ERP) focuses on the gradual exposure of the feared situation or trigger to reduce or eliminate the anxiety symptoms.

Trauma-focused Cognitive Behavior Therapy (TF-CBT) is an evidenced based treatment model that has been proven to reduce trauma related symptoms. This treatment is often used for treating Posttraumatic Stress Disorder but is also effective in treating various traumatic impacts. Using TF-CBT, clinicians work collaboratively with the individual and their family to provide psychoeducation about the impact of traumatic experiences. The client and their family learn to manage distressing thoughts, feelings, and behaviors that are linked to the traumatic event. The family also learns effective communication skills and strategies to increase feelings of safety in the sufferer.  

Additionally, scientific research has categorized Eye Movement Desensitization and Reprocessing (EMDR) an evidenced-based therapy, as effective for the treatment of trauma. EMDR is a treatment technique that facilitates the reprocessing of traumatic memory. In this treatment, the patient focuses on sound, movement, or lights to guide eye movements, while recalling the traumatic event using gradual exposure. This method helps reprocess the memory and the sufferer’s reaction to it.

Resources

Acute and Posttraumatic Stress Disorders in Children and Adolescents
Merck
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Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
American Psychiatric Association. (2013).
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Johns Hopkins Medicine;
https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Psychiatry_Guide/787067/all/Acute_Stress_Disorder

Support Groups for Acute Distress Disorder
NetworkTherapy.com
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Treatment for Teen Acute Stress Disorder
Paradigm Malibu
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