Acute Stress Disorder and Posttraumatic Stress Disorder (PTSD) both happen after a psychologically traumatic event. A traumatic event is one in which a person is exposed to actual or threatened death, serious injury, or sexual violation (APA, 2013). In the DSM-5, they are listed under the category “Trauma- and Stressor-Related Disorders.”

Symptoms:

The symptoms of acute stress disorder and PTSD are almost same. Those are:

•          Re-experiencing the Event

People have unwanted thoughts, memories, dreams, or nightmares about the trauma. Some have flashbacks, where they feel like the event is happening again.

•          Avoidance

People avoid places, activities, thoughts, or conversations that remind them of the trauma.

•          Reduced Emotional Response

People feel detached from other people or lose interest in activities that once brought enjoyment. Some experience symptoms of dissociation, or psychological separation, where they feel dazed, forget things, or feel like the world around them isn’t real.

•          Increased Arousal and Negative Feelings

They may feel:

- overly alert (hyperalert)

- easily startled

- have trouble sleeping or

- find it hard to focus.

Many feel anxious, angry, depressed, or guilty—especially if they survived while others didn’t or if they had to do something to survive.

If the symptoms begin within 4 weeks of the traumatic event and last for less than a month, DSM-5 assigns a diagnosis of acute stress disorder (APA, 2013). If the symptoms continue longer than a month, a diagnosis of posttraumatic stress disorder (PTSD) is given. The symptoms of PTSD can start soon after a traumatic event or even months or years later. Around 80% of people with acute stress disorder later develop PTSD.

 

Why People Develop Acute and PTSD?

There are different point of views about why people develop Acute and PTSD. Some of them are biological factors, childhood experiences, personal styles, social support systems, and the severity and nature of the traumas.  Here are detailed information about these:

1. Biological and Genetic Factors

Researchers have found some biological and genetic factors that linked with these disorders. Those are:

•          Stress chemicals:

Abnormal activity of hormone cortisol and norepinephrine have been found in the urine, blood, and saliva of people who went through extreme stress—such as soldiers, rape victims, concentration camp survivors, and others.

•          Brain circuits:

These are networks of brain structures that trigger each other into action to produce various emotional reactions. In PTSD, one circuit seems to work abnormally. This circuit includes the hippocampus and amygdala:

oThe hippocampus controls memory and stress hormones. a dysfunctional hippocampus produce the intrusive memories and constant arousal found in PTSD.

oThe amygdala controls anxiety and emotional responses. It also works with the hippocampus to create emotional memories. A dysfunctional amygdala produce the emotions and memories in PTSD.

•          Genetic transmission:

PTSD may even pass on biological changes to children. For example, researchers found unusual cortisol levels in women who were pregnant during the September 11, 2001 terrorist attacks and later developed PTSD.

2. Personality

Personality is an enduring characteristic. People with certain personality traits, attitudes, are more likely to develop acute stress disorder (ASD) or (PTSD).

For example: children who had high trait anxiety (tendency to be anxious most of the time) were more likely to develop severe stress reactions than other children.

People who think they have no control over bad events in life often develop stronger stress symptoms after a traumatic event than those who believe they have some control.

3. Childhood experiences

Certain childhood experiences can make people more likely to develop acute stress disorder (ASD) or (PTSD) later in life. For example,

 the risk is higher for people who:

•          Grew up in poverty

•          Experienced abuses

•          Had parents who divorced or separated before age 10

•          Had family members with psychological disorders

4. Social Support

People whose social and family support systems are weak are also more likely to develop acute or PTSD after a traumatic event.

For example: Rape victims who feel loved, valued, and accepted by friends and family recover better. Poor social support contributes to the development of posttraumatic stress disorder in some combat veterans.

5. Multicultural Factors

The rates of PTSD are not the same in all ethnic groups in the U.S. Research shows that Hispanic Americans may be more vulnerable than others.

One reason is that many Hispanic Americans, because of cultural beliefs, see traumatic events as something unavoidable and unchangeable. Another reason is the weak social relationships and support.

6. Severity of Trauma

The severity and nature of the trauma determines whether the person will develop a stress disorder. Generally, the more severe the trauma and the exposure to it, the higher the chance of developing a stress disorder.

For example: Experiences like severe injury, or sexual abuse increase the chance of stress reactions.


Treatment for PTSD:

Treatment procedures for PTSD often vary from trauma to trauma.

1. Treatment for Combat Veterans:

Therapists uses a variety of techniques to reduce veterans’ posttraumatic symptoms. Such as:

•          drug therapy,

•          behavioral exposure techniques,

•          insight therapy,

•          family therapy, and

•          group therapy.

Antianxiety drugs help control the tension that many veterans experience. In addition, antidepressant medications may reduce the occurrence of nightmares, panic attacks, flashbacks, and feelings of depression.

Behavioral exposure techniques, too, have helped reduce specific symptoms, and they have often led to improvements in overall adjustment.

A common type of exposure therapy is Eye Movement Desensitization and Reprocessing (EMDR). In this method, people move their eyes side to side in a rhythmic way while thinking about the things they usually try to avoid.

Veterans who have posttraumatic stress disorder may be further helped in a couple, family, or group therapy format.

2. Psychological Debriefing

People who go through disasters, accidents, or victimization often get the same treatments as combat survivors. Since these traumas happen in their own community, where mental health services are available, they may also benefit from quick help in the community.

One common approach is called psychological debriefing (or critical incident stress debriefing). It has been widely used for the last 30 years.

Psychological debriefing is a type of crisis intervention where victims talk in detail about their feelings and reactions within a few days of the traumatic event.