DIAGNOSING 'ACUTE STRESS

REACTION', 'PTSD', 'ADJUSTMENT

DISORDER' AND 'OTHER
REACTIONS TO SEVERE STRESS'
Niharika Sharma 25a
Acute Stress
Reaction
◦ Acute stress reaction (ASR) is a psychological condition that can
develop in response to a traumatic event, such as a natural disaster,
physical or sexual assault, serious accident, or sudden loss of a
loved one. ASR typically develops within minutes to hours after
the traumatic event and can last for up to several days or weeks.
◦ According to ICD – 10 :
◦ Symptoms begin within hours to days after a stressful event
◦ Presence of dissociative symptoms, including derealization or
depersonalization
◦ Symptom duration is usually less than four weeks
◦ Symptoms cause significant distress or impairment in functioning
◦ Symptoms are not better explained by other disorders
◦ According to ICD-11 :
◦ Exposure to a traumatic event
◦ Presence of dissociative or re-experiencing symptoms -
◦ Individual has experienced at least three of the following symptoms, which must have developed
within four weeks of the traumatic event:
Repeated and intrusive memories, flashbacks or dreams related to the traumatic event
Avoidance or efforts to avoid reminders of the traumatic event
Negative changes in mood or emotions, such as feelings of fear, anger, guilt, or shame
Hyperarousal or increased physical arousal, such as difficulty sleeping, irritability, or hypervigilance
◦ Symptom duration is between two days to four weeks
◦ Symptoms cause significant distress or impairment in functioning
◦ Symptoms are not better explained by other disorders
Post-traumatic stress disorder
◦ Post-traumatic stress disorder (PTSD) is a psychological condition that can develop in some individuals
who have experienced or witnessed a traumatic event, such as military combat, physical or sexual
assault, natural disasters, serious accidents, or other life-threatening events.
◦ According to ICD-10 :
◦ Exposure to a traumatic event
◦ Presence of re-experiencing, avoidance, and hyperarousal symptoms
◦ Symptom duration is at least one month
◦ Symptoms cause significant distress or impairment in functioning
◦ Symptoms are not better explained by other disorders
◦ According to ICD-11 :
◦ Exposure to a traumatic event
◦ Presence of re-experiencing, avoidance, and hyperarousal symptoms
◦ Symptom duration is at least one month
◦ Symptoms cause significant distress or impairment in functioning
◦ Symptoms are not better explained by other disorders
◦ Finally, the individual experiences at least two of the following arousal and reactivity symptoms:
◦ Irritability or outbursts of anger
◦ Hypervigilance
◦ Problems with concentration
◦ Sleep disturbances
Adjustment
Disorder
◦ Adjustment disorder (AD) is a
psychological condition that can
develop in response to a stressful
life event, such as a divorce, job
loss, serious illness, or financial
difficulties. AD typically occurs
within three months of the stressful
event and can last for up to six
months after the event has ended.
◦ According to ICD - 10 :
◦ Development of emotional or
behavioral symptoms within three
months of a stressor
◦ Symptoms are more severe than
would be expected given the
stressor
◦ Symptoms cause significant distress
or impairment in functioning
◦ Symptoms are not better explained
by other disorders
◦ According to ICD-11 :
◦ Development of emotional or behavioral symptoms within three months of a stressor
◦ Symptoms are more severe than would be expected given the stressor
◦ Symptoms cause significant distress or impairment in functioning
◦ Symptoms are not better explained by other disorders
◦ The individual experiences significant emotional or behavioral symptoms in response to the stressor.
The symptoms must include at least one of the following:
◦ Depressed mood
◦ Anxiety or worry
◦ A feeling of being overwhelmed
◦ Difficulty in adjusting to the stressful life event
◦ Mixed anxiety and depressed mood
◦ Conduct disturbances, which may be aggressive or destructive
Other reactions to
severe stress
Other reactions to severe stress are psychological conditions that can
develop in response to a traumatic or stressful event, but do not meet the
criteria for PTSD or AD
◦ According to ICD-10 :
◦ Development of symptoms within days or weeks of exposure to
severe stressors
◦ Symptoms include emotional numbness, dissociation, or anxiety
◦ Symptoms cause significant distress or impairment in functioning
◦ Symptoms are not better explained by other disorders
◦ According to ICD-11 :
◦ Acute stress disorder (ASD): Similar to PTSD, ASD is characterized by symptoms of intrusive re-
experiencing, avoidance, and hyperarousal. However, the symptoms occur within four weeks of the
traumatic event and last for no more than four weeks.
◦ Reactions to severe stress and adjustment disorders (RSAD): This category includes reactions to
severe stress that do not meet the criteria for ASD or AD. RSAD may be characterized by symptoms
such as anxiety, depression, irritability, or conduct disturbances.
◦ Prolonged grief disorder (PGD): PGD is a condition that can develop in response to the death of a
loved one. It is characterized by persistent and intense grief that lasts for more than six months and is
associated with functional impairment.
◦ Dissociative disorders: These are conditions that involve a disruption in consciousness, memory, or
identity, and can occur in response to severe stress. Examples of dissociative disorders include
dissociative amnesia, dissociative fugue, and depersonalization/derealization disorder.
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