Mental Disorders

Acute Stress Reaction

Acute stress reaction (also called acute stress disorder, psychological shock, mental shock, or simply shock) is a condition arising in response to a terrifying or traumatic event, or witnessing a traumatic event that induces a strong emotional response within the individual. It should not be confused with the unrelated circulatory condition of . Acute stress reaction (ASR) may develop into delayed stress reaction (better known as ) if stress is not correctly managed. ASR is characterized by re-living and avoiding reminders of an aversive event, as well as generalized hypervigilance after initial exposure to a traumatic event. ASD is differentiated from PTSD as a disorder that precedes it, and if symptoms last for more than one month, it will develop into PTSD. It can thus be thought of as the acute phase of PTSD .

Signs and Symptons

The DSM-IV specifies that ASD must be accompanied by the presence of dissociative symptoms, which largely differentiates it from PTSD.

Dissociative symptoms include a sense of numbing or detachment from emotional reactions, a sense of physical detachment, such as seeing oneself from another perspective, decreased awareness of one's surroundings, the perception that one's environment is unreal or dreamlike, and the inability to recall critical aspects of the traumatic event (dissociative amnesia).

In addition to the characteristic dissociative symptoms, ASD shares many of the symptoms with PTSD, including:

the experience or witnessing of a threatening event that resulted in intense fear or horrorthe re-experiencing of the event by means of flashbacks, recurrent thoughts or dreams, and distress when reminded of the eventthe avoidance of stimuli that serve as reminders of the event, such as feelings, thoughts, places, individuals, and activitiesanxiety, including restlessness, difficulty sleeping and concentrating, and hypervigilancea significant disruption in normal social or work functioning

Causes

There are several theoretical perspectives on trauma response, including cognitive, biological, and psychobiological. While the theories are PTSD-specific, they are still useful in understanding ASD, as both share many symptoms.

Acute stress disorder (abbreviated ASD, and not to be confused with ) is the result of a in which the person experiences or witnesses an event that causes the victim/witness to experience extreme, disturbing, or unexpected fear, stress, or pain, and that involves or threatens serious injury, perceived serious injury, or death to themselves or someone else. A study of rescue personnel after exposure to a traumatic event showed no gender difference in acute stress reaction. Acute stress reaction is a variation of (PTSD).

A recent study found that a single stressful event may cause long-term consequences in the brain. This result calls the traditional distinction between the effects of acute vs chronic stress into question.

Diagnosis

There must be a clear temporal connection between the impact of an exceptional stressor and the onset of symptoms; onset is usually within a few minutes or days but may occur up to one month after the stressor. In addition, the symptoms show a mixed and usually changing picture; in addition to the initial state of "daze," depression, anxiety, anger, despair, overactivity, and withdrawal may all be seen, but no one type of symptom predominates for long; the symptoms usually resolve rapidly in those cases where removal from the stressful environment is possible; in cases where the stress continues or cannot by its nature be reversed, the symptoms usually begin to diminish after 24–48 hours and are usually minimal after about 3 days. 

Treatment

This disorder may resolve itself with time or may develop into a more severe disorder such as PTSD. However, results of Creamer, O'Donnell, and Pattison's (2004) study of 363 patients suggests that a diagnosis of acute stress disorder had only limited predictive validity for PTSD. Creamer et al. did find that re-experiences of the traumatic event and arousal were better predictors of PTSD. Early pharmacotherapy may prevent the development of posttraumtic symptoms.