Acute stress disorder (ASD) is a similar diagnosis to post traumatic stress disorder (PTSD). It occurs after a traumatic event and is diagnosed (instead of post traumatic stress disorder) if symptoms occur between two days and a month after the traumatic event. The symptoms of acute stress disorder are very similar to those seen in post traumatic stress disorder; re-experiencing the event, avoidance of stimuli associated with the event and increased arousal symptoms.
The development of the acute stress disorder diagnosis has caused controversy among practitioners. It is often criticised for pathologising short term reactions to trauma which are common, and to be expected. However, despite this criticism, it is important to note that more than two thirds of those diagnosed with acute stress disorder develop post traumatic stress disorder within two years. Therefore, effective treatment is important not only to relieve acute stress disorder, but also to reduce the chances of the development of post traumatic stress disorder (Kring et al, 2007).
The Use of Cognitive-behavioural Therapy in Overcoming Acute Stress Disorder
The single most effective and popular way of overcoming acute stress disorder is short term cognitive-behavioural therapy. Five or six sessions are usually offered, and include prolonged imaginal exposure, cognitive therapy and anxiety management. Exposure is the crucial component, as it has been recognised that exposure is a necessary component in treating any anxiety disorder effectively. Cognitive therapy allows the restructuring of distorted cognitions that arise from the traumatic event, and anxiety management is used to counteract the fear conditioning that is seen in post traumatic stress disorder and is caused by elevated arousal during the traumatic event. Anxiety management alone has been seen to immediately reduce symptoms, however, an exposure component is necessary for long term effectiveness (Bryant et al, 1999).
Other Treatments for Overcoming Acute Stress Disorder
In addition to cognitive-behavioural therapy, other forms of treatment are offered to help being overcome acute stress disorder. However, these vary in effectiveness and none measure up to cognitive-behavioural therapy. One such treatment is supportive counselling, comprised of non-directive counselling and problem solving. Supportive counselling does reduce the chance of post traumatic stress disorder developing in cases of acute stress disorder, although not as well as cognitive-behavioural therapy. It can reduce increased arousal symptoms and re-experiencing, however it does not appear to reduce avoidance symptoms (Bryant et al, 1999).
However, any intervention is not always better than no intervention. Critical incident stress debriefing is another treatment that is offered to those suffering acute stress disorder. It is offered to anyone who has experienced a trauma within 72 hours, regardless of whether they are showing symptoms, so patients may not always have acute stress disorder. Critical incident stress debriefing takes place in one long session in which people are encouraged to remember the details of the event and express their feelings. This form of treatment is highly controversial as patients have tended to become more likely to develop acute stress disorder or post traumatic stress disorder after receiving critical incident stress debriefing than after receiving no therapy. It is suggested that in the very early stages after a trauma victims are better off being supported by family and friends and not being forced to recall the event. Indeed, it is likely that some of those subjected to critical incident stress debriefing would not have developed acute stress disorder had they not been forced to reflect on the event before they were ready (Kring et al, 2007).
Bryant, R.A., Sackville, T., Dang, S.T., Moulds, M. & Guthrie, R. (1999) Treating acute stress disorder: an evaluation of cognitive behaviour therapy and supportive counselling techniques. The American Journal of Psychiatry, 156, 1780-1786.
Kring, A.M., Davison, G.C., Neale, J.M. & Johnson, S.L. (2007) Abnormal Psychology. USA: John Wiley & Sons.
This post is part of the series: Treatments for Post Traumatic Stress Disorder
- How to Overcome Acute Stress Disorder
- The Benefits of Occupational Therapy Treatment for Post Traumatic Stress Disorder
- Prolonged Exposure Therapy for PTSD