Acute stress disorder refers to a brief period of intrusive memory that occurs within 4 weeks after a person witnesses or becomes overwhelmed with an overwhelming traumatic experience.
In an acute stress disorder, people have experienced a traumatic experience, experiencing it directly (for example, as a serious injury or death threat) or indirectly (for example, learning things that have happened to others, learning from events experienced by other family members or close friends to have).
Those affected have recurring memories of the trauma, avoiding all the stimuli that might remind them of the trauma, and have increased vegetative excitability. The symptoms begin within 4 weeks of the traumatic event and last at least 3 days and, in contrast to post-traumatic stress disorder, no longer than 4 weeks. People with this disorder may experience dissociative symptoms.
- Clinical criteria
The diagnosis is based on the criteria recommended in the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition (DSM-5); these criteria include dissociative symptoms.
To meet the criteria for diagnosis, patients must have been directly or indirectly exposed to a traumatic event, and ≥ 9 of the following must be present for a period of 3 days to 1 month:
- Recurring, involuntary and intrusive burdening memories of the event
- Recurring disturbing dreams of this event (eg nightmares)
- Dissociative reactions (eg, flashbacks) in which patients feel as if the traumatic event is recurring.
- Intense mental or physical stress when remembering the event (eg anniversary or similar sounds heard during the event)
- Persistent inability to experience positive emotions (eg happiness, contentment, loving feelings)
- A changed sense of reality (eg the feeling of drowsiness, slowed down time, changed perceptions)
- Inability to remember an important part of the traumatic event
- Efforts to avoid the tormenting memories, thoughts, or feelings associated with the event
- Efforts to avoid external memories (people, places, conversations, activities, tasks, situations) related to the event.
- Sleep disorders
- Irritability or temper tantrums
- Difficulty concentrating
In addition, the manifestations must cause significant suffering or substantially impair social or occupational function and not be attributed to the physiological effect of a substance or other medical condition.
- Non-pharmacological measures
Many people recover as soon as they can leave the traumatic situation, gain understanding and empathy, and get the gullibility to describe the event and its response.
To prevent or minimize this disruption, some experts recommend a systematic debriefing of individuals who have themselves been exposed to or witnessed a traumatic event so they can better handle the experience and its effects. One form of debriefing calls the event a critical incident and debriefing a critical incident stress debriefing (CISD).
Other experts have expressed concern, and some studies show that CISD may not be as helpful as a supportive, empathic conversation and that it can be quite onerous for some patients and even hamper normal recovery.
Light sleep aids can be helpful in the short term, other medicines are i. Gen. but not displayed.
Diagnosis according to DSM-5
In the Diagnostic and Statistical Manual of Mental Disorders – DSM-5 is Acute stress disorder (Acute Stress Disorder DSM-IV 308.3) defined as a disease in which the victims had been confronted with an event that the actual or threatened death, serious injury or risk to the physical integrity of their own or others.
Sufferers can experience this stressful event
- have experienced on your own person,
- have observed in other people
- have learned that this event has taken close family members or close friends or
- repeatedly confronted with the burdensome consequences of such an event (eg as members of the rescue service or social aid organizations).
In addition, to be able to diagnose Acute Stress Disorder, the following criteria must be met:
The Acute Stress Disorder must have started within 1 month of the traumatic event and must have persisted for at least 3 days and not more than 1 month. The differential diagnosis should be thought to be an adjustment disorder or a posttraumatic stress disorder (DSM-IV 309.81) for a longer duration.
Those affected experience at least nine (or more) of the following symptoms:
- Repeated compelling memories of the trauma.
- Repeated nightmares related to the trauma.
- Dissociation, eg Flashbacks.
- Strong suffering from stimuli reminiscent of the trauma.
- Inability to perceive positive emotions.
- Depersonalization or derealization.
- Inability to remember certain aspects of the trauma.
- Avoidance of thoughts, etc. that remind of the trauma.
- Avoidance of external factors reminding of the trauma.
- Irritability and angry outbursts.
- Difficulty concentrating.
- Exaggerated startle reaction.
In addition, the symptoms should not be due to the direct physical effects of a substance (such as drugs or drugs) or due to a physical disease factor, nor better explained by a brief psychotic disorder.
The symptoms must clinically meaningfully cause suffering or impairment in social, occupational or other important functional areas, or limit the ability of those affected to perform necessary tasks.