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Acute Stress Disorder and Post-Traumatic Stress Disorder (PTSD)

 

Acute stress disorder refers to the anxiety and behavioral disturbances that develop within the first month after exposure to an extreme trauma. Generally, the symptoms of an acute stress disorder begin during or shortly following the trauma. Such extreme traumatic events include rape or other severe physical assault, near-death experiences in accidents, witnessing a murder, and combat. The symptom of dissociation, which reflects a perceived detachment of the mind from the emotional state or even the body, is a critical feature of this disorder. Dissociation also is characterized by a sense of the world as a dreamlike or unreal place and may be accompanied by poor memory of the specifics of the traumatic event. Other features of an acute stress disorder include symptoms of generalized anxiety and excessive arousal, avoidance of situations or things that elicit memories of the trauma, and persistent, intrusive recollections of the event via flashbacks, dreams, or recurrent thoughts or visual images.

If the symptoms and behavioral disturbances of the acute stress disorder persist for more than 1 month, and if these features are associated with functional impairment or significant distress to the sufferer, the diagnosis is changed to post-traumatic stress disorder. Because post-traumatic stress disorder lasts longer than acute stress disorder, a number of changes, including decreased self-esteem, loss of sustained beliefs about people or society, hopelessness, a sense of being permanently damaged, and difficulties in previously established relationships, tend to occur. Substance abuse often develops, especially the abuse of alcohol, marijuana, and sedative-hypnotic drugs.

About 50 percent of cases of post-traumatic stress disorder improve considerably within 6 months. For the remainder, the disorder typically persists for years and can dominate the sufferer’s life. The highest rates of post-traumatic stress disorder are found among women who are victims of crime, especially rape, as well as among torture and concentration camp survivors. Overall, among those exposed to extreme trauma, about 9 percent develop post-traumatic stress disorder.

 

An excerpt from Mental Health: A Report of the Surgeon General, U.S. Department of Health & Human Services.


 

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