Exposure to a traumatic event, whether or not the individual is directly involved, can lead to a state known as Acute Stress Disorder (ASD). The symptoms associated with ASD are, acute stress, amnesia, detachment, depersonalization and derealization. These symptoms, collectively known as dissociative reactions, will tend to occur during the traumatic event or up to a month later.
The American Psychiatric Association describes a person with ASD as, ‘experiencing difficulty concentrating, feeling detached from their bodies, experiencing the world as unreal or dreamlike, or having increasing difficulty recalling specific details of the traumatic event.'
When the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was published, it expanded the category of Post Traumatic Stress Disorder (PTSD) to include ASD. Some commentators have suggested that evidence of ASD indicates that a person is likely to live with trauma for a considerable time. Others point to the fact that PTSD frequently develops with or without signs of ASD and have questioned its relevance as a subclass of PTSD.
The person with ASD will try to avoid events or situations that remind them of the trauma. Any triggering of memories may lead to quite marked reactions involving extreme anxiety, hypervigilance, irritability and restlessness. Poor concentration and broken sleep will feature and will help to feed the stress reaction.
The main emphasis with ASD is the dissociative symptoms experienced during, or following trauma. A diagnosis of ASD may be reached if any three symptoms from derealization, depersonalization, amnesia, reduced awareness of surroundings or a subjective sense of feeling numb, detached, or lack of emotional responsiveness are evident. Flashbacks, recurring images and isolated memories, nightmares and a sense of reliving the event time after time are features of an ASD disturbance. However, a diagnosis of ASD will only be reached if these features are known to impair social or work activities and last for at least two days or up to four weeks during the disturbance. They must also feature within four weeks of the trauma.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Washington, D.C: American Psychiatric Association.
Rachman, S (2004) Anxiety, second edition. Psychology Press.
Published On: May 05, 2009