Acute stress disorder overview
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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
Historical Perspective
Acute stress disorder was first described in 1920 by Walter Cannon.[1]
Classification
Pathophysiology
The exact pathogenesis of acute stress disorder is not fully understood. It is thought that acute stress disorder is caused by either sympathetic nervous system, both directly and indirectly through the release od adrenaline and to a lesser extent noradrenaline from the medulla of the adrenal glands, or hypothalamic-pituitary-adrenal axis.[1]
Causes
Acute stress disorder may be caused by either experiencing, witnessing, or being confronted with one or more traumatic events.[2][3][4][5]
Differential Diagnosis
Acute stress disorder must be differentiated from other diseases that closely mimic a range of acute stress disorder symptoms, including depersonalization, derealization, reduced awareness, and dissociative amnesia or from disorders that doesn't meet criteria for acute stress disorder such as post traumatic stress disorder, obsessive-compulsive disorder, anxiety disorders, depression, dissociative disorders, panic disorder, adjustment disorder, effects of analgesic medications, medical conditions involving coma or impaired awareness, effects of substance abuse, traumatic brain injury (TBI), exacerbation of a preexisting mental condition, brief psychotic episode, and psychotic disorders.
Epidemiology and Demographics
The point prevalence of acute stress disorder (ASD) following trauma exposure has been estimated at between 5 and 20 percent. Females are more commonly affected with acute stress disorder than males.[6][7][8][9][10][11]
Risk Factors
Common risk factors in the development of acute stress disorder are temperamental, environment, and genetic and physiological.[12][13][14][15][16]
Screening
Natural History, Complications, and Prognosis
If left untreated, 50% of patients with acute stress disorder may progress to develop post traumatic stress disorder. Common complications of acute stress disorder include interference with sleep, energy levels, and capacity to attend to tasks, generalized withdrawal, and progression to post traumatic stress disorder. Prognosis is generally good, and the majority of individuals experiencing acute stress disorder recover completely. If the disorder lasts more than 4 weeks, a significant percentage will develop posttraumatic stress disorder (PTSD). Of individuals who have cognitive-behavioral therapy (CBT) shortly after frightening events, only about 10% to 20% develop PTSD.
Diagnosis
Diagnostic Criteria
he diagnosis of acute stress disorder is based on the DSM-5 diagnostic criteria, which include criterion A i.e the exposure to actual or threatened death, serious injury, or sexual violation in one (or more) of the following ways such as directly experiencing the traumatic event(s), witnessing, in person, the event(s) as it occured to others, learning that the event(s) occured toa close family member or close friend, and experiencing repeated or extreme exposure to aversive details of the traumatic event(s), criterion B i.e presence of nine (or more) of the symptoms from any of the five categories of intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred, criterion C i.e duration of the disturbance (symptoms in Criterion B) is 3 days to 1 month after trauma exposure, criterion D i.e the disturbance causes clinically significant distress or impairment in social, occupational,or other important areas of functioning, and criterion E i.e the disturbance is not attributable to the physiological effects of a substance (e.g., medication or alcohol) or another medical condition (e.g., mild traumatic brain injury)and is not better explained by brief psychotic disorder.[17]
History and Symptoms
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.
Physical Examination
Laboratory Findings
Chest X Ray
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Psychotherapy
Primary Prevention
Secondary Prevention
References
- ↑ 1.0 1.1 extramammary Paget's disease. Wikipedia(2015) https://en.wikipedia.org/wiki/Acute_stress_reaction Accessed on February 07, 2016
- ↑ Bryant, Richard A., et al. "A review of acute stress disorder in DSM‐5." Depression and anxiety 28.9 (2011): 802-817.
- ↑ Classen, Catherine, et al. "Acute stress disorder as a predictor of posttraumatic stress symptoms." American Journal of Psychiatry (1998).
- ↑ Elklit, Ask, and Dorte M. Christiansen. "ASD and PTSD in rape victims." Journal of Interpersonal Violence (2010).
- ↑ Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association, 2013. Print.
- ↑ Holeva, Vassiliki; Tarrier, Nicholas; Wells, Adrian (2001). "Prevalence and predictors of acute stress disorder and PTSD following road traffic accidents: Thought control strategies and social support". Behavior Therapy. 32 (1): 65–83. doi:10.1016/S0005-7894(01)80044-7. ISSN 0005-7894.
- ↑ Harvey AG, Bryant RA (1998). "The relationship between acute stress disorder and posttraumatic stress disorder: a prospective evaluation of motor vehicle accident survivors". J Consult Clin Psychol. 66 (3): 507–12. PMID 9642889.
- ↑ Brewin CR, Andrews B, Rose S, Kirk M (1999). "Acute stress disorder and posttraumatic stress disorder in victims of violent crime". Am J Psychiatry. 156 (3): 360–6. doi:10.1176/ajp.156.3.360. PMID 10080549.
- ↑ Creamer, Mark; Manning, Carolyn (1998). "Acute Stress Disorder Following an Industrial Accident". Australian Psychologist. 33 (2): 125–129. doi:10.1080/00050069808257393. ISSN 0005-0067.
- ↑ Harvey AG, Bryant RA (1999). "Acute stress disorder across trauma populations". J Nerv Ment Dis. 187 (7): 443–6. PMID 10426466.
- ↑ Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association, 2013. Print.
- ↑ Harvey AG, Bryant RA (1999). "Predictors of acute stress following motor vehicle accidents". J Trauma Stress. 12 (3): 519–25. doi:10.1023/A:1024723205259. PMID 10467559.
- ↑ Harvey AG, Bryant RA (1998). "Predictors of acute stress following mild traumatic brain injury". Brain Inj. 12 (2): 147–54. PMID 9492962.
- ↑ Barton KA, Blanchard EB, Hickling EJ (1996). "Antecedents and consequences of acute stress disorder among motor vehicle accident victims". Behav Res Ther. 34 (10): 805–13. PMID 8952123.
- ↑ Guthrie RM, Bryant RA (2005). "Auditory startle response in firefighters before and after trauma exposure". Am J Psychiatry. 162 (2): 283–90. doi:10.1176/appi.ajp.162.2.283. PMID 15677592.
- ↑ Blatchley FR, Donovan BT (1976). "Progesterone secretion during pregnancy and pseudopregnancy in the ferret". J Reprod Fertil. 46 (2): 455–6. PMID 1255579.
- ↑ Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.