Abstract
People today are exposed to highly stressful life situations. This challenging scenario raises potential threats to their physical and mental health. Psychological practitioners indicate that increased life stress accounts for a significant percent of mental health problems in the United States. The aim of this paper is to explore different aspects of trauma and stressor related disorders such as Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD). Although both these disorders have almost similar characteristics, the duration of impacts is different for ASD and PTSD. In a statistical study, it appears that the incidence rate of ASD and PTSD has increased notably over the years. It is alarming to see that nearly 8% of Americans are victims of PTSD at any given time. Experiencing or witnessing a traumatic event like a brutal murder, accident, or a rape can be a potential cause leading to ASD or PTSD. Compared to ASD, PTSD is a more dangerous stress disorder affecting the normal life of victims for a long period. The key point of difference between ASD and PTSD is that the symptoms of ASD would last for only a maximum of one month whereas PTSD symptoms may last for several months. In both circumstances, patients need strong support of their family members and friends to get rid of the memories of traumatic events and to come back to a normal life. Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) provides specific criteria for the diagnosis of both ASD and PTSD. When derealization, depersonalization, and dissociative amnesia are some of the most common recognized symptoms of ASD, PTSD has four types of symptoms including intrusive memories, avoidance, negative thinking, and negative changes in emotional reactions. Antidepressants are mainly employed to treat ASD whereas PTSD is treated best using a combination of medication and psychotherapy.
Introduction
Trauma and stressor related disorders occur when a person is exposed to a traumatic or stressful event. Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) are the major trauma and stressor related disorders. ASD and PTSD are almost similar except that ASD occurs immediately after the traumatic/stressful event and lasts up to one month whereas PTSD may last more than one month. It is identified that PTSD may occur “either as a continuation of ASD or as a separate occurrence up to 6 months after the trauma” (Greist, 2014). In the past, trauma and stressor disorders were treated as anxiety disorders. However, they are recognized distinct because many victims have symptoms of anger, aggression, or dysphoria instead of having anxiety symptoms. Trauma and stressor related disorders such as ASD and PTSD can horribly affect human lives and it would be really difficult for victims to return to a normal life unless they obtain timely and proper treatment. A good understanding of trauma and stressor related disorders is vital for victim’s family members who have a crucial role to play in patient recovery. This paper will critically evaluate different aspects of trauma and stressor related disorders, focusing specifically on ASD and PTSD.
Trauma and Stressor Related Disorders
Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) identify seven trauma and stressor related disorders including posttraumatic stress disorder, acute stress disorder, adjustment disorders, reactive attachment disorder, disinhibited social engagement disorder, other specific trauma and stressor related disorder, unspecified trauma and stressor related disorder (Sweeton, n.d.). In this paper, the two most common trauma and stressor related disorders, ASD and PTSD, are discussed.
Acute Stress Disorder (ASD)
1. Overview and statistics
Acute stress disorder (ASD) develops in an individual when he is exposed to certain physical/psychological stress. Acute stress reactions would last only for hours or days. The stress may be developed as a result of a traumatic experience like accident or physical assault or as a result of an unexpected change in social situations like a family member’s death. Statistical studies published on U.S Department of Veterans Affairs (n.d.) suggest that 13-21% of motor vehicle accident survivors are likely to develop ASD. A study of a typhoon survivors indicated that ASD occurrence rate was 7% when another study of industrial accident victims showed that ASD rate was 6%. In addition, another study of robbery and assault victims demonstrated that 23% of them met the criteria for ASD while this figure was 33% in case of mass shooting victims (U.S Department of Veterans Affairs).
2. Causes and symptoms
Exposure to traumatic events involving intense fear, horror, or helplessness can be the main reason for ASD. To be precise, the major causes leading to ASD include a death, a threat of death, a threat of serious injury, and/or a threat to the physical integrity. The ASD has a number of dissociative symptoms. Mainly, the individual will appear to be emotionally unresponsive or detached and he will be less aware of his surroundings. Derealization is another major symptom of ASD that occurs when the individual finds his environment strange to him. Another dissociative symptom is depersonalization, which implies that a person’s thoughts and emotions will not belong to him seemingly. Finally, dissociative amnesia is also a symptom of ASD and it occurs when the victims finds difficulty in remembering one or more key aspects of the traumatic event. An individual has developed ASD if he has three or more of the dissociative symptoms described above.
3. Risk factors and complications
Although anyone can develop ASD, some people are specifically at the risk of developing this stress disorder. A person who has experienced or witnessed a traumatic event in the past is likely to be diagnosed with ASD in future. In addition, a previous history of ASD or PTSD increases an individual’s vulnerability to ASD. Individuals with a history of certain mental problems are highly prone to developing this mental disorder. If the person has experienced dissociative symptoms during the traumatic events, he has a great chance of developing ASD.
4. Diagnosis and treatment
The DSM-5 has set specific criteria for the diagnosis of ASD. In order to be diagnosed with ASD, a person has to meet the criteria specified in DSM-5. “An exposure to actual or threatened death, serious injury, or sexual violation” is the major criterion stated in DSM-5 for the diagnosis of ASD (Bryant et al, 2010). When it comes to the treatment of ASD, a comprehensive psychiatric evaluation of the patient is required to assess one’s specific needs. In addition, immediate hospitalization of the patient is needed if he shows a suicidal tendency or violent behavior. The victim has to be given assistance with attaining shelter, food, and relocation if necessary. It is recognized that antidepressants and selective serotonin reuptake inhibitors (SSRIs) are effective for treating people with ASD (Nica & Links, 2011). Cognitive therapy is also effective for patients with ASD to achieve a fast recovery and to prevent ASD from turning into PTSD. Finally, in certain cases, exposure-based therapies and hypnotherapy may be used to improve the clinical outcomes of ASD patients.
5. Prevention and management
Actually, there is no method to prevent the development of ASD in individuals because it is impossible to ensure that people are not exposed to traumatic events. However, there are some approaches to reduce a person’s probability of developing ASD. Seeking medical assistance within hours of experiencing or witnessing a terrifying event would limit a person’s risk of ASD. People doing high-trauma exposure jobs such as military personnel and first responders should be given proper training and counseling to overcome the shock of a traumatic event. For those people, fake enactment of traumatic events is a better way to cope with the pressures of real-life traumatic exposures.
Posttraumatic Stress Disorder (PTSD)
1. Overview and statistics
Experiencing or witnessing a tarrying event may cause an individual to develop PTSD. It is important to note that every people exposed to a traumatic event may not necessarily develop PTSD. According to statistical data published on PTSD United Plc’s website, approximately 70% of US people have experienced some sorts of terrifying events in their lives and 20% of those shocking experiences have turned to PTSD. As of today, nearly 44.7 million US people were or are struggling with PTSD. Another interesting data is that an approximate 8% of Americans are victims of PTSD at any given time and this number equals the total population of Texas. It is also observed that one out of every nine women is likely to develop PTSD in their lifetime (PTSD United).
2. Causes and symptoms
A person may develop PTSD if he/she goes through a shocking event such as a brutal homicide, serious injury, or a violent sexual assault. Studies suggest that inherited mental health risks such as anxiety and depression may increase an individual’s risk of developing PTSD. Normally, the symptoms of PTSD may begin to appear within three months of a traumatic event but in some cases the symptoms will be hidden until years after the event. PTSD symptoms can be grouped into four types including intrusive memories, avoidance, negative thinking, and negative changes in emotional reactions. Intrusive memories may include flashbacks of traumatic events, upsetting dreams, or extreme reactions to something that reminds the terrifying event. Avoidance implies that the victim tries to avoid places, activities, or situations that would remind him/her of the traumatic event.
3. Risk factors and complications
Earlier experiences of traumatic events in life such as childhood abuse make an individual vulnerable to the risk of PTSD. In addition, military personnel and first responders, whose job requires exposure to traumatic events, are at a greater risk of PTSD (Iversen et al, 2009). If people are affected by mental health problems like anxiety or depression, they are also prone to developing this disorder. Lack of support from family and friends and blood relationships with people having mental health problems are other factors increasing an individual’s risk of PTSD. It is identified that PTSD can extremely trouble an individual’s whole life including job, relationships, and daily activities. According to psychological practitioners, the major complications of PTSD include suicidal thoughts, depression and anxiety, drug/alcohol abuse, and eating disorders.
4. Diagnosis and treatment
A close observation of signs and symptoms together with a thorough psychological examination is vital to diagnose the presence of PTSD. Being published by American Psychiatric Association, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides a set of criteria for the diagnosis of PTSD. In order to be diagnosed with PTSD, a person has to meet these criteria. According to DSM-5, the diagnosis of PTSD requires the victim’s exposure to a traumatic event like “threat of death, violence, or serious injury” (Mayo Clinic staff). In addition, the individual has to experience any of the signs or symptoms stated in DSM-5 after the traumatic event. A combination of psychotherapy and medication are used to treat PTSD. There are different types of psychotherapy used for treating PTSD including cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing (EMDR) (Jeffries & Davis, 2013). The major types of medications that are used to improve the symptoms of PTSD include antidepressants, anti-anxiety medications, and prazosin.
5. Prevention and management
Getting proper support from family members, relatives, and friends following a traumatic event can help the victim prevent the development of PTSD. When the victim is in the comfort zone of his family and friends who will listen to his worries and anxieties, he can quickly survive the trauma. In addition, the victim may seek the assistance of mental health provider for a brief course of therapy. For some people, it would be better to turn toward their faith community to get rid of the memories of a terrifying event. Proper support from family, friends, and/or faith community would help victims prevent normal stress reactions turning into PTSD. It may also benefit victims for avoiding unhealthy coping methods such as alcohol or drug abuse.
Conclusion
References
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