Acute stress disorder history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Symptoms of acute stress disorder include dissociative symptoms, symptoms of reexperiencing the traumatic event, avoidence symptoms, symptoms of anxiety or increased arousal, symptoms of distress, chaotic and impulsive behavior, and post-concussive symptoms.
History
- Since traumatic events can lead to a wide variety of emotional reactions, the treating clinician must understand that underneath the individual’s reaction is an attempt to cope with the traumatic event. The majority of individuals have some symptoms after a significant traumatic event. However, a minority have sufficient symptoms to fulfill the diagnostic criteria for acute stress disorder (ASD).
- All trauma victims may not want or need professional assistance. Individuals who refuse help may not be in denial, but may see themselves as more resilient or able to rely on the support of friends and family. Physicians should support patients who want to talk about their experience, but should not push those who prefer not to seek professional help. Early management and identification of acute stress disorder can decrease the percentage of patients who develop post traumatic stress disorder.
- All patients should have a thorough assessment of psychiatric and medical history, with particular attention paid to the following:[1]
- Baseline mental status
- Baseline functional status
- Medical history to include any injury such as mild traumatic brain injury (TBI)
- Medications to include medication allergies and sensitivities such as prescription medications, nutritional or herbal supplements, and over-the- counter (OTC) medications (caffeine, energy drinks or use of other substances)
- Past psychiatric history to include prior treatment for mental health and substance use disorder, and past hospitalization for depression or suicidality
- Current life stressors.
Symptoms
- Individuals with acute stress disorder may experience panic attacks in the initial month after trauma exposure that may apparently occur spontaneously or may be triggered by trauma reminders.
- There may be significant separation anxiety, in children, possibly manifested by excessive needs for attention from caregivers.
- In bereavement following a death that occurred in traumatic circumstances, the symptoms of acute stress disorder can involve acute grief reactions. In such cases, reactions to the loss may involve reexperiencing, dissociative, and arousal symptoms, such as intrusive memories of the circumstances of the individual’s death, anger about the death, disbelief that the individual has died.
- The symptoms of acute stress disorder may vary cross-culturally, particularly with respect to dissociative symptoms, avoidence, nightmares, and somatic symptoms. Cultural syndromes and terminology of distress shape the symptom profiles of acute stress disorder. In the initial months after trauma exposure some cultural groups may display variants of dissociative responses, such as possession or trancelike behaviors. Panic symptoms may be salient in acute stress disorder among Cambodians because of the association of traumatic exposure with panic-like khyâl attacks.[2][3][4][5][6][7][8][9][10][11]
- Patients may complain of loss of appetite, changes in weight, trouble going to sleep or staying asleep, fatigue, and hair loss
Symptoms of acute stress disorder may include the following:
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Individuals may drive recklessly, make irrational decisions, or gamble excessively |
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References
- ↑ Susskind O, Ruzek JI, Friedman MJ (2012). "The VA/DOD Clinical Practice Guideline for Management of Post-Traumatic Stress (update 2010): development and methodology". J Rehabil Res Dev. 49 (5): xvii–xxviii. PMID 23015590.
- ↑ Ehlers, A; Mayou, R.A; Bryant, B (2003). "Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study". Behaviour Research and Therapy. 41 (1): 1–10. doi:10.1016/S0005-7967(01)00126-7. ISSN 0005-7967.
- ↑ Warda G, Bryant RA (1998). "Cognitive bias in acute stress disorder". Behav Res Ther. 36 (12): 1177–83. PMID 9745802.
- ↑ Dunmore E, Clark DM, Ehlers A (2001). "A prospective investigation of the role of cognitive factors in persistent posttraumatic stress disorder (PTSD) after physical or sexual assault". Behav Res Ther. 39 (9): 1063–84. PMID 11520012.
- ↑ Smith K, Bryant RA (2000). "The generality of cognitive bias in acute stress disorder". Behav Res Ther. 38 (7): 709–15. PMID 10875192.
- ↑ Bryant RA, Panasetis P (2001). "Panic symptoms during trauma and acute stress disorder". Behav Res Ther. 39 (8): 961–6. PMID 11480836.
- ↑ Nixon RD, Bryant RA (2003). "Peritraumatic and persistent panic attacks in acute stress disorder". Behav Res Ther. 41 (10): 1237–42. PMID 12971943.
- ↑ Bryant, R. (2011). Post-traumatic stress disorder vs traumatic brain injury. Dialogues in Clinical Neuroscience, 13(3), 251–262.
- ↑ Meares S, Shores EA, Taylor AJ, Batchelor J, Bryant RA, Baguley IJ; et al. (2008). "Mild traumatic brain injury does not predict acute postconcussion syndrome". J Neurol Neurosurg Psychiatry. 79 (3): 300–6. doi:10.1136/jnnp.2007.126565. PMID 17702772.
- ↑ Kirmayer, Laurence J. (1996). "Confusion of the senses: Implications of ethnocultural variations in somatoform and dissociative disorders for PTSD": 131–163. doi:10.1037/10555-005.
- ↑ Hinton DE, Lewis-Fernández R (2011). "The cross-cultural validity of posttraumatic stress disorder: implications for DSM-5". Depress Anxiety. 28 (9): 783–801. doi:10.1002/da.20753. PMID 21910185.