Acute Stress Reaction and Acute Stress Disorder

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Table of Contents

Introduction
Differences between Acute Stress Disorder and Acute Stress Reaction
Diagnostic Criteria for Acute Stress Reaction
Treatment of Acute Stress Disorders
Treatment Strategies
Effects to Human Life
Risk Factors
Conclusion
References

Introduction

Acute Stress response, also termed as psychological shock or mental shock, is psychosomatic state of affairs resulting to reactions to a frightening or hurtful situation. However, the term is frequently confused with another related condition called acute stress disorder. It should be noted that the two are different in a number of ways.

Walter Cannon explained acute stress reaction as a condition whereby animals respond to threats, with general discharge of sympathetic nervous system. Psychology scholars developed the theory in subsequent years and arrived at a conclusion that it is a general adaptation syndrome, which controls stress reactions among all vertebrates, as well as other organisms.

It therefore follows that the reaction of the body towards a stress is linked to specific physiological acts in the sympathetic nervous system. This could be either direct response or indirect response, which would be through the discharge of adrenaline or at least noradrenalin (Jeffrey, & Everly, 1996). This would be discharged from the medulla of the adrenal glands.

Stress reaction is a complex process because catecholamine hormones are in charge of facilitating instant physical responses by simply triggering augmented heart rate, as well as breathing.

When this happens, blood vessels are constricted hence facilitating spontaneous or intuitive behaviors that would be associated to combat or in some cases escape.

On the other hand, acute stress disorder is the outcome of a traumatic state of affairs that an individual experiences. It also occurs when an individual comes across an event that might lead him or her to experience severe, disconcerting or unpredicted fear, anxiety or pain.

Such pain might perhaps threaten an individual leading to serious injury, perception of a serious harm or even his or her own death or death of another person. From the definition, acute stress reaction is different from acute stress disorder.

In fact, acute stress reaction is a variant to post-traumatic stress disorder. In other words, it is the reaction of the body or the mind towards the deep feelings, which might be either perceived or real feelings. In this case, an individual feels helpless (Bryant, 2000).

This paper will attempt to differentiate between acute stress response and acute stress disorder. The paper will go a notch higher to discuss the symptoms, treatment strategies, including spiritual and professional treatment, and finally the impact of the symptoms to human behavior.

Differences between Acute Stress Disorder and Acute Stress Reaction

The conditions of stress differ more as regards to symptoms. For acute stress reaction, the victim feels an initial state of shock with a number of limitations in terms of consciousness and contraction of attention.

Moreover, an individual develops a unique condition that makes him or unable to comprehend the body stimuli, which might actually disorient an individual. When this happens, an individual tends to withdraw from the rest of societal members.

In this regard, an individual would develop weird behavior including confrontation and over activity, nervousness, defective decision-making, mystification, lack of involvement, and misery. In addition, signs of panic are also witnessed such as tachycardia, fret, flushing.

These symptoms are differentiated from those of acute stress disorder because they appear within few hours of the stressful event. However, the symptoms disappear within two to three days (Creamer, O’Donnell, & Pattison, 2004). Partial or complete loss of memory may precede these symptoms.

For acute stress disorder, instantaneous and clear connection, which might be temporal impact of an outstanding stressor, must exist. The symptoms occur after a few hours or it might even take a few days. In other words, the signs of the disorder do not take place immediately as is the case with acute stress reaction condition.

Some of the symptoms of acute stress disorder include deadening, impassiveness, detribalization, depersonalization or dissociative forgetfulness, continual re-experiencing of the incident by such ways as reflections, imaginings, and flashbacks. The victim keeps on evading any inspiration that reminds him or her of the stressful episode (Lambert, 2004).

The symptoms are easy to differentiate from those of acute stress reaction because during this time, victims must show other symptoms such as nervousness and considerable impairment in at least one critical area of functioning such as the nervous system.

Symptoms last for at least 2 days, and utmost 4 weeks, and takes place within 4 weeks of the horrifying incident.

Diagnostic Criteria for Acute Stress Reaction

When an individual is suspected to be suffering from stress after being exposed to a traumatic event, some of the symptoms are to be observed first before declaring that an individual suffers from Acute Stress Disorder.

One of the steps to be undertaken by an expert is to evaluate whether an individual actually underwent a stressful event that would lead to trauma. This would include assessing whether the event threatened the life of the victim or the life of another person but was witnessed by the victim.

It would also involve emotional injury whereby the reputation of the individual was maliciously destroyed. Another thing to observe is an individual’s response to the stressful event. For instance, did the victim respond with fear and horror or did the victim feel helpless.

The second thing to do is to check whether an individual experienced some of the symptoms as mentioned below. The victim could have experienced a subjective sense of numbing, aloofness or could have gone through emotional receptiveness. The patient could have experienced a reduction in consciousness as regards to his or her environment such as being in a state of shock.

Serialization could be another sign of acute stress disorder. The fourth symptom to be aware of is depersonalization. Finally, the patient could as well undergo dissociative amnesia, which is associated with lack of a significant aspect of trauma. It should be noted that the patient should experience at least three or more of the above symptoms to be declared sick (Johnson, 1997).

The third aspect associated with diagnosis is the aspect of re-experienced traumatic event. The event should recur in one of the following ways: repeated imagery, reflections, imaginings, false impressions, flashback incidents, or a sense of reliving the incident.

The fourth guideline pertains to marking the avoidance of stimuli in patients that would probably stimulate memories of the trauma such as reflections, feelings, chats, actions, places and the community. In case the patient portrays some of these then he or she would probably be suffering from acute stress disorder.

The fifth guideline is related to noting the symptoms of nervousness or increased stimulation. This would include sleeping, irritability, poor attentiveness, hyperactivity, embellished amazing response and motor restiveness. The sixth diagnostic guideline relates to observing the social actions of the patient.

The patient would develop some of the actions that are not friendly to his or her relatives, family members or even co-workers. The individual might fail to accomplish some of the basic tasks, even those that he or she used to execute before the occurrence of the event.

An individual would perhaps require assistance in simple activities. Another guideline is to observe the time that is, monitor the time that the individual would start behaving differently. It is supposed to take at least two days and utmost four weeks.

The last guideline is related to assessing the psychological status of the individual. Usually, the individual is supposed to be disturbed. The disturbances are not a result of drugs.

Treatment of Acute Stress Disorders

Before recommending treatment of acute stress disorders, the caregiver needs to undertake a number of assessments. For instance, he or she needs to consider the type of the event that caused the condition, as well as the available resources.

Recommendation for treatment would depend on the traumatic event for instance victims of sexual assault are given different treatment from those who underwent a natural disaster such as floods. Furthermore, the caregiver is to assess the damage caused by the traumatic event.

It is recommended that those victims going through large-scale catastrophes are to be evaluated to determine the triage of individuals at danger of psychiatric sequelae. Moreover, the available resources would help the caregiver determine the type of treatment. In case the victim is in danger, the caregiver is to address individual needs such as clinical care, rest nutrition and avoidance of injury related aspects.

Moreover, the caregiver is to take into consideration factors such as symptom rigorousness, comorbid physical or psychiatric analysis, desperate and murderous ideation, strategies, or objective level of functioning and accessible support methods.

The psychologist is to consider the patient’s individual security, the capacity to care for self sufficiently, capacity to provide consistent response to the psychiatrist, and enthusiasm to take part in treatment and capacity to belief in clinicians and the treatment procedure.

While undertaking or recommending treatment, the caregiver needs to observe some issues that might affect the treatment process. In this regard, the caregiver should carry out assessment and treatment with a lot of seriousness implying that treatment should be undertaken in a serene, safe environment.

This would probably necessitate development of trust on the side of the patient. In addition, some patients might be having some fears as regards to re-exposure to the traumatic event. The caregiver needs to acknowledge such fears and encourage the patient to take heart.

In some instances, treatment might turn out to be a threatening or even an overly intrusive process. Therefore, the caregiver should tackle the concerns of the patient and make sure that the treatment preferences are suitable to the patient.

Treatment Strategies

There are two forms of treatment for acute stress disorders. They include psychopharmacology and psychotherapy. The strategies are employed under different circumstances. Both will be discussed in detail.

Regarding psychopharmacology, experts claim that there is no ideal pharmacological intervention to acute stress disorder. However, a number of drugs have been suggested to cure the disorder.

Effects of acute stress disorder can be minimized through the intake of selective serotonin reuptake inhibitors (SSRIs). The drug is recommended because of a few reasons. One of the reasons is that it ameliorate the three PTSD signs, including re-experiencing of the event, forestalling and hyperactive arousal.

The drug is known to treat psychiatric disorders that tend to be frequently comorbid in relation to PTSD, such as despair, fear disorder, social fear and obsessive-compulsive disarray.

Experts prefer the drug strategy because it has the capability of reducing clinical signs, including suicidal, impetuous and destructive actions. Such symptoms usually complicate the management process of PTSD.

Some practitioners prefer using anticonvulsant tablets such as divalproex, carbamazepine, topiramate and lamotrigine. The drug is preferred over SSRIs because it cures specifically the signs of re-experiencing, which threatens the mental health of the victim.

In case the SSRIs are found ineffective in eradicating comorbid psychotic disorders, health experts would resort to the use of second-generation antipsychotic medications such as olanzapine and quitipine.

The drug is effective in terms of controlling the symptoms. For rare complications such as the emergence of extraordinary symptoms, patients are given specialized treatment using adrenergic agonists and adrenergic blockers (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995).

The most common strategy employed by doctors and other medical personnel in the treatment of acute stress disorders is the psychotherapy treatment. The method is more effective as compared to other strategies because it aims at restoring the patient back to his or her normal status without consumption of substances.

One of the methods of psychotherapy treatment is the cognitive and behavior rehabilitation. The technique aims at eradicating appraisal processes by employing repeated exposure practice or by utilizing some techniques aiming at providing information to the victim without undertaking repeated exposure technique.

In some parts of the world, caregivers recommend the use of eye movement desensitization and reprocessing technique (EMDR). In this technique, the caregiver aims at helping the victim to shift attention from the traumatizing event to something else that would make him or her more comfortable.

Even though some practitioners view the technique as ineffective, proper utilization of the method has proven to be efficient, just as other techniques of cognitive therapy. Another treatment strategy employs psychodynamic and psychotherapy method (Koocher, Erin, & Krista, 2001).

The strategy focuses on the importance of the trauma to the patient as regards to psychological conflicts. The method analyzes the effects of the trauma to the self-esteem of the patient.

Effects to Human Life

An acute stress disorder is known to affect an individual’s social interaction in society since it interferes with an individual’s behavior, societal development and the ecosystem.

In a disastrous situation for example, an individual is believed to act irrationally meaning people act out of panic and fear. Some individuals might be unable to think clearly, while others might make uninformed decisions.

A section of the victims is usually tempted to move in masses, which brings about humanitarian crises. However, studies show that flight panic occurs rarely (Mills, Edmondson, & Park, 2007).

Some patents tend to ignore the instructions of crisis workers after realizing that their properties have been destroyed. Such patients give rescue workers a difficult time since crisis workers are forced to engage in hazardous searches, which puts their lives in danger (Van der Kolk, McFarlane, & Weisaeth, 1996.).

Antisocial behavior should not be ruled out after the occurrence of a disaster. Antisocial behavior in this sense constitutes three major aspects, one being the aspect of looting. Some of the victims, especially those from the low social class would claim to assist in the rescue mission whereas their ultimate goal is to loot.

Some victims may perhaps engage in acts of violence to protect their interests (Mahoney, Chandra, Gambheera, De Silva, & Suveendran, 2006). The last aspect of antisocial behavior as regards to acute stress disorder is related to price gauging.

On development, acute stress disorders are known to retard economic, social and political development of an affected family. Studies show that patients suffering from acute stress disorder owing to natural disasters tend to neglect the social well-being of families.

In this case, disastrous events increase the poverty rates and deprive the community of its valued resources that are utilized in fulfilling daily needs. A study conducted in the US confirmed that a disaster reduces the growth of an affected region by 0.8 percent. Disasters have been accused of causing social inequalities in societies.

The earthquakes in China affected those who had already suffered from societal injustices in terms of ownership of property. The victims suffered from income fluctuations and had little access to monetary services such as loans and mortgages.

After the earthquake, the victims were even affected more (Dattilio, & Freeman, 1994). They had difficulties in acquiring some of the basic goods and their standards of living depreciated further. The rich were not affected so much in terms of capital because a majority of them had insured their properties.

Risk Factors

One of the risk factors includes severity of the exposure. Those victims who could have been involved directly to the disaster tend to suffer more as opposed to those who could have been affected indirectly. Such victims tend to take more time in terms of recovering from the disastrous event.

Another risk fact is the gender of the victim. Studies show that women and girls tend to be affected more as opposed to men and boys (Breslau, 1990). Furthermore, those with families are affected more, given the fact that they have to provide for their families in case they are breadwinners. Another specific risk factor to the Sichuan earthquake is the region.

China is considered a third world country meaning that it does not have proper measures for handling traumatizing events. One of the resilience factors is coping confidence. Many victims tend to behave as if the event is too much for them and they cannot recover easily. This affects the healing process.

Those victims full of confidence usually recover faster as compared to those who believe that the situation is bearable for them. Communities that do not embrace social support tend to suffer from recovery. Social support augments the individual’s well-being and restricts distress after any disastrous event (Slaby, 1998).

Conclusion

Acute stress disorders affect the living standards of individuals in various ways. For instance, it interferes with the normal functioning of the brain. Patients suffering from the disorder tend to make uninformed decisions that might put their lives in danger.

Before declaring that an individual suffers from acute stress disorder, a number of guidelines are to be observed. In other words, the symptoms associated with acute stress disorder are to be evaluated and monitored by the caregiver closely.

Treatment strategies depend on the severity of the situation and the nature of the stressful event. Therefore, the caregiver is to subscribe treatment based on the effects of the disorder and the nature of the traumatizing event.

In terms of the effects of the disease, it manifests in many ways. Some individuals might develop antisocial behavior while others might turn out to be unreliable members of society. Factors, such as the region, age, social status and educational level of the victim affect the coping strategies.

References

Breslau, N. (1990). Stressors: Continuous and discontinuous. Journal of Applied Social Psychology, 20(20), 1666-1673.

Bryant, R.A. (2000). Acute Stress Disorder. PTSD Research Quarterly, 11(2), 1-7.

Creamer, M., O’Donnell, M.L., & Pattison, P. (2004). Acute stress disorder is of limited benefit in predicting post-traumatic stress disorder in people surviving traumatic injury. Behavior Research and Therapy, 42(2), 315-328

Dattilio, F., & Freeman, R. (1994). Cognitive-Behavioral Strategies in Crisis Intervention. New York: Guilford.

Jeffrey,M., & Everly, G. (1996). Critical Incident Stress Debriefing: An Operations Manual for the Prevention of Traumatic Stress among Emergency Services and Disaster Workers. Ellicott City, MD: Chevron.

Johnson, S. (1997). Therapist’s Guide to Clinical Intervention: The 1-2-3s of Treatment Planning. New York: Academic Press.

Kessler, R.C., Sonnega, A., Bromet, E.J., Hughes, M., & Nelson, C.B. (1995). Posttraumatic Stress Disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048-1060.

Koocher, G., Erin K., & Krista, E. (2001). Medical Crisis Counseling in a Health Maintenance Organization: Preventive Intervention. Professional Psychology: Research and Practice, 32(1), 52–58.

Lambert, M.J. (2004). Bergin and Garfield’s Handbook of Psychotherapy and Behavioral Change. New York: Wiley.

Mahoney, J., Chandra, V., Gambheera, H., De Silva, T., & Suveendran, T. (2006). Responding to the mental health and psychosocial needs of the people of Sri Lanka in disasters. International Review of Psychiatry, 18(6), 593–597.

Mills, M. A., Edmondson, D., & Park, C. L. (2007). Trauma and stress response among Hurricane Katrina evacuees. American Journal of Public Health, 97, S116–S123.

Slaby, A. (1998). Risk Management with Suicidal Patients. New York: Guilford,.

Van der Kolk, C., McFarlane, A., & L. Weisaeth, H. (1996.). Traumatic stress: The effects of overwhelming experience on mind, body, and society. New York: Guilford Press.

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