While experiencing extremely traumatic stressors like physical assault or witnessing accidental death or soon after it occurs, a person may show major changes in behavior, thought & emotions. These changes stem from intense fear, helplessness or horror associated with the event. Acute Stress Disorder is marked by symptoms of dissociation that include a subjective sense of numbness, detachment & absence of emotional responsiveness. These symptoms indicate a disruption in the usually integrated functions of consciousness, memory, identity & perception of the environment & are referee to as dissociative symptoms.
While other symptoms might also be present in acute stress disorder, what is clinically clearest is the linkage between a traumatic experience & dissociative symptoms. To make the diagnosis of Acute Stress Disorder, DSM-IV-TR requires that the disturbances last for at least 2 days & at most 4 weeks after the traumatic event. As with adjustment disorder, people diagnosed as having an acute stress disorder are expected to recover in a relatively short period of time. Persons suffering from acute stress disorder show high level of anxiety & arousal, & they are often unable to keep from thinking with intense emotion about the traumatic event. Consequently, they reexperience the trauma.
The pic attached shows major diagnostic criteria for acute stress disorder. Clinician interviews with persons who may have an acute stress disorder usually include the following types of questions which are intended to determine whether the diagnostic criteria have been met. ( Brayan & Harvey 2000)
1. During or since the event, have you felt numb or distant from your own emotion?
2. During or since the event, have things around you seemed unreal?
3. Have you had bad dreams or nightmares about the event?
4. Have you avoided people or places or activities that may remind you of the event?
5. Since the event, have you had difficulty concentrating?
6. Since the event, have you felt unusually irritable or have you lost your temper a lot more than usual?
( ASD was included in DSM classification system in 1994)
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