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Acute Stress

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Acute Stress

Acute Stress

Mindy DeLone

August 18, 2013


Acute stress reactions and acute stress disorder are not one in the same.  They of course are related very closely with one leading to the other.  It is important to know what is normal and what is abnormal about stress in order to help a person who has gone through a critical event and may be in a state of crisis.  Traumatic events can affect people in different ways and counselors need to know how to handle these cases in a variety of different ways.  This paper will explore the definitions of the two, along with the causes, diagnosis and treatment of the two.  

Acute Stress

        The first thing that needs to be looked at is, what is stress?  Stress is the “physiological changes that occur when a person experiences difficulties or pressures in life” (Clinton, Hart, & Ohlshlager, 2005).  Some of the things that occur when a person is experiencing stress are a fast heart rate, rapid or shallow breathing, increased muscle tension, loss of concentration, avoidance behaviors, sleep and appetite disturbance and depression (Clinton, Hart, & Ohlshlager, 2005). These are all normal and natural things that happen to people when they are stressed.  They are also the things that counselors need to look out for when they are treating someone who has been through a traumatic event.  Although these things are considered normal reactions to stress, they also need to run their course to be considered normal.  If these reactions to stress continue and do not get better, this is when a person may need to seek outside help to deal with their stress.  


        Acute stress disorder (ASD) was added as a new diagnosis for the DSM-IV. The disorder was created “in recognition that an abnormally stressful event may lead may people to experience significant distress and impairment within the weeks immediately following the event that may mandate clinical intervention” (Koopman, Classen, Cardena, & Spiegel, 1995). The word acute is included to say that they symptoms happen within four weeks of the traumatic event (Koopman, Classen, Cardena, & Spiegel, 1995).  Acute stress disorder is considered to be the younger sister of post-traumatic stress disorder (PTSD) (James, 2008). ASD’s symptoms look a lot like those of PTSD, but the difference is that the disturbance lasts for at least two days and occurs within four weeks of the traumatic event (James, 2008).  What are acute stress reactions then, they are the immediate reactions to the stressful event.  Acute stress reactions to a traumatic event can include anxiety, dissociative, and depressive symptoms (Spiegel, 2005).

Symptoms and Diagnosing

        A person who suffers from ASD may experience anxiety-based symptoms like intrusive thoughts, nightmares, irritability, and restlessness.  They may also suffer from dissociative symptoms including numbness, amnesia, reliving, depersonalization, and derealization, and depressive symptoms (Spiegel, 2005).  Most of the time people that suffer from these symptoms will recover spontaneously, but some will go on to develop PTSD (Spiegel, 2005).

        To be diagnosed with ASD a person must meet several criteria.  The first criteria is that the person “must have experienced an event that virtually anyone would find distressing, that involves actual or threatened death or serious injury, or a threat to the physical integrity of self or others, and person reacted to this event with intense fear, horror or helplessness” (Koopman, Classen, Cardena,  & Spiegel, 1995).  There are also four categories of symptoms that have to present for a person to be diagnosed with ADS: “dissociative symptoms, anxiety symptoms, re-experiencing the traumatic event, and avoiding reminders of the event” (Koopman, Classen, Cardena, & Spiegel, 1995).  All the symptoms must also interfere with a person’s social and occupational life or prevent the person from completing a necessary task (Koopman, Classen, Cardena, & Spiegel, 1995).  


        There are many different way ideas on how to treat ADS.  The most popular way and what seems to be the most successful way to treat ADS is exposure therapy (Scott, Nipper, & Smith, 2010).  One study from 2009 shows “re-exposure to memories of the traumatic even, when started within three months of the event, is more effective than supportive counseling for adults with ADS, supportive counseling is more effective than no treatment at all” (Scott, Nipper, & Smith, 2010).  Exposure therapy has been so successful in treating different disorders that it has become a big part of most behavioral and cognitive behavioral treatments for anxiety disorders (Corey, 2009).  A 2007 meta-analysis showed that medication should not be substituted for therapy which is more effective than medication (Scott, Nipper, & Smith, 2010).  

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