Acute Stress Disorder (ASD): (A Comprehensive Guide)

In this guide we are going to give an overview of the acute stress disorder (ASD) in detail and would discuss various contributing factors, symptoms, diagnostic aspects and treatment options that are available. 

Acute Stress Disorder

Acute Stress Disorder, also known as ASD, is one of the psychological ailments that manifests after being exposed to a traumatic experience.

The medical definition of ‘trauma’ is a serious injury and requires an emergency treatment.

Likewise, psychological interpretation of ‘trauma’ is of an experience that has been extremely distressing and would most likely contribute towards a long lasting psychopathology. 

Although, stress in response to any traumatic instance is, primarily, an essential and automatic phenomenon.

However, the person who has experienced a trauma often struggles to deal with the accompanying distress and it becomes difficult to let it all go.

This inability to move forward and put the traumatic experience behind has strong psychological and physiological aspects. 

Primarily acute stress disorder diagnosis was formulated in order to screen out those who run a high risk of developing post-traumatic stress disorder.

Looking back in history during the World War-I, acute stress disorder (ASD) was labelled as ‘shell-shock’ because of the overlap in symptoms of those who were injured by the explosion of shells or bombs and suffered a concussion damaging the nervous system.  

Precipitating Factors of ASD

Anyone who has undergone a traumatic experience is at risk for developing acute stress disorder, soon after the incident.

The likelihood of developing pathology increases with an increase in incident-severity and frequency of occurrence. 

These events function like precipitating factors that make the individual susceptible towards ASD symptomatology by weakening the psychological immunity.

Following are some of the broader categories or types of incidents (whether direct or indirect exposure) that carry a high risk of developing ASD: 

  • Witnessing ‘death’ of a loved one, or having a ‘near death’ experience
  • Having a threat of dying (related to a loved one or self)
  • Having a threat of extreme injury or 

At-Risk Populations for ASD:

One of the misconceptions about stress related disorders is that the only ones at risk are those who have been directly involved in the incident (referred to as ‘direct exposure’).

As a matter of fact, even those who have witnessed a traumatic event would be at risk of developing acute stress disorder or other stress related conditions.

For instance, anyone who has had a direct exposure to an accident, an episode of violence or a natural calamity would fall in the direct exposure category.

While, the indirect exposure would encompass individuals who have only witnessed an incident. 

Risk of developing acute stress disorder would also increase for those who have a pre-existing psychological ailment (esp, having a history of dissociation or PTSD or ASD).

In addition to the direct or indirect exposure to trauma, even being exposed to violent graphic content may increase the risk of developing acute stress disorder. 

Prevalence of Acute Stress Disorder: 

It is hard to ascertain the exact percentage of those who are suffering from Acute Stress Disorder.

However, according to an estimate by U.S Department of Veterans Affairs, as many as 33% of people who undergo a traumatic event develop acute stress disorder.

The risk percentage varies in accordance with the unique nature of any situation. 

Detailed Symptomology of ASD

The symptom profile of acute stress disorder (ASD) overlaps quite a lot with that of post traumatic stress disorder (PTSD).

Usually, the symptoms start manifesting soon after the trauma and may last for months (or days). 

Generally, the individual suffering through ASD or stress related disorders would have recurrent mental psychological recall of the traumatic incident and may employ avoidance mechanisms to stay away from the potential triggers or situations that are similar to the traumatic incident.

Sufferers of ASD may also have dissociation or emotional numbness that make them feel disconnected and give them a sense of surrealism. 

DSM-V Symptom Categories for Acute Stress Disorder

The Diagnostic and Statistical Manual-V, outlines about five exclusive categories of acute stress disorder:

  1. Symptoms of Intrusion: These symptoms are very much involuntary and the person experiencing them would have no control over them. In addition to their involuntary nature, they are also “intrusive” (as apparent from the label) with distressing recollection of the traumatic incident or a sequence of recurrent dreams that depict the distressing details of past trauma. 
  1. Symptoms of Negative Mood: These symptoms are related to experiencing an excess of negative emotions and a lack of position ones (e.g. love or joy). 
  1. Symptoms of Dissociation: These symptoms include a strange sense of unreality and detachment from oneself. Individuals who are suffering from acute stress disorder and are experiencing dissociative symptoms report a sense of time slowing down or feeling as if they have been observing themselves from the perspective of an outsider. Patients also report the dissociative phase as a state of being in a daze. 

People who are suffering from ASD and experiencing dissociative symptoms would often experience about 3 (or more) of these symptoms:

  1. Having feelings of detachment, numbness or being unresponsive emotionally or anhedonia.
  1. Feelings of derealization that would make the person feel as if everything around is unreal (more like a dream state) and a deep sense of strangeness about the surroundings.
  1. The sufferer would have diminished awareness of the surroundings.
  1. A state of depersonalization, during which the patient would feel as if their emotions and thoughts aren’t real or don’t belong to them. 
  1. Experiencing dissociative-amnesia, that would happen when the sufferer would be unable to recall some significant details of the traumatic incident. 
  1. Symptoms of Avoidance: These symptoms are concerned with active attempts to avoid stimuli that risk triggering the trauma related content. This may include avoidance of thoughts, memories, feelings, places or people that are linked with the traumatic incident. 
  1. Symptoms of Anxiety or Arousal: The symptoms that are concerned with state of arousal often disturb sleep habits and other cognitive-behavioral aspects of everyday functioning of the sufferer. The individuals suffering from ASD and experiencing arousal symptoms would often report difficulty falling asleep or staying asleep for a longer duration. 

They also report several cognitive disturbances, the most common of which is concentration problems. In general, patients with problems of arousal would also experience irritability and other behavioral issues. The symptoms of increase in arousal or anxiety may include:

  1. Feeling excessive irritability,
  2. Having a hard time while concentrating on everyday tasks, 

Treatment Options

People who suffer from ASD or stress can develop health conditions like Episcleritis. Therefore, it is very important to treat ASD as soon as possible.

Generally the treatment course for the management of acute stress disorder (ASD) is as follows:

  • The first thing that happens is a detailed and comprehensive psychiatric examination to identify chonicity and pathological profile and to identify unique needs of each client (patient),
  • There may be a need for immediate hospitalization to consistently monitor the patient, if he/she has been experiencing suicidal ideation or intent to harm self-or-others,
  • The patient may also be provided with required help that would be unique to each person’s needs but may include locating a family member or family, obtaining clothing, shelter or food etc. 
  • The patient may also be offered psycho-education in order to help him/her understand the nature of presenting problems and their management course.
  • In order to manage the symptoms appropriately, administration of pharmacotherapy may be required and anxiolytics or antidepressants may be prescribed. 
  • One of the most popular and commonly used therapeutic interventions is ‘cognitive behavioral therapy (CBT) that speeds up the overall recovery process and prevents further precipitation of pathology. 
  • In addition to pharmacotherapy and CBT, the clinician may also utilize hypnotherapy and exposure-based therapies. However, the treatment plan is always uniquely tailored to fit the individual needs and presenting problems. 

Some Helpful Resources

  1. There is a book entitled, Acute Stress Disorder: What It Is and How to Treat It   that aims to help the parents or guardians in understanding the psychopathology of acute stress. The book also offers helpful strategies. 
  1. The book entitled, Posttraumatic And Acute Stress Disorder  is also great in offering an understanding and way to manage this disorder.
  1. Reading “Acute Stress Disorder: A Handbook of Theory, Assessment, and Treatment” would also offer great insight into how to resolve this problem.
  1. Another book, entitled, 30 Day Journal & Tracker: Reversing Acute Stress Disorder: The Raw Vegan Plant-Based Detoxification & Regeneration Journal & Tracker for Healing is great way to journal your way to health and well-being.
  1. The book entitled,  Post-Traumatic and Acute Stress Disorders  is also great in offering an understanding and way to manage this disorder.

However, the resources listed above are only to guide and provide information.

As a rule of thumb, you must always seek professional help from trained experts. 

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Conclusion

Acute stress disorder is a chronic illness and may not be taken for granted or left to be settled on its own.

In order to avoid further symptom precipitation or harm from suicidal ideation and to prevent the development of PTSD, timely treatment should be sought from professional and certified health practitioners. 

Frequently Asked Questions:

Can I prevent ASD?

Acute stress disorder may not be preventable, as it is nearly impossible to avoid traumatic occurrences.

However, people who are suffering from acute stress disorder may reduce the disabling impact by seeking timely help through mental health counseling or psychotherapy.

What is the difference between acute stress disorder and PTSD?

The primary difference between acute stress disorder (ASD) and Post Traumatic Stress Disorder (PTSD) is in the time of occurrence of these disorders.

ASD usually happens right after the traumatic incidence while PTSD would manifest as a problem in the long run (after the traumatic incident).

Moreover, a diagnosis of acute stress disorder would have dissociation symptomology, while a diagnosis of PTSD would have dissociative sub-type.

How long does it does ASD last?

The length or duration of pathology in the case of acute stress disorder or ASD is persistent symptom presentation for at-least 3 days and the symptoms should not persist one month after the traumatic incident.

Can acute stress disorder turn into PTSD?

Yes and no; as it is not a confirmed course of illness in all of the cases.

Acute stress disorder may not always lead to PTSD.

Although, both the disorders have very similar symptom profile and are essentially a ‘response’ to a traumatic incident. 

How many people are affected by acute stress disorder?

According to an estimate, about 5%-20% individuals who have suffered a trauma or have been exposed to a traumatic incident may be diagnosed with acute stress disorder or ASD.

Moreover, approximately 50% of those diagnosed with ASD would develop PTSD pathology eventually. 

What is acute stress and chronic stress?

Generally, acute stress is categorized as short term and chronic stress is identified as long term stress.

Acute stress happens to be among the least debilitating stress-types and it also the most prevalent one. 

References:

  1. Psychcentral -Acute stress disorder symptoms
  2. medicalnewstoday.
  3. healthline
  4. aafp.org
  5. emedicine.medscape
  6. childmind.org

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