Acute Stress Disorder and Posttraumatic Stress Disorder

• Traumatic experiences can lead to the development of traumatic stress disorders, which are characterized by maladaptive patterns of behavior in response to trauma that involve marked personal distress or significant impairment of functioning.
• Acute stress disorder (ASD) – A traumatic stress reaction in which the person shows a maladaptive pattern of behavior for a period of three days to one month following exposure to a traumatic event.
• Posttraumatic stress disorder (PTSD) – A prolonged maladaptive reaction to a traumatic event.

• People with acute stress disorder may feel they are “in a daze” or that the world seems like a dreamlike or unreal place.
• Acute stress disorder may occur in response to battlefield trauma or exposure to natural or technological disasters.
• Stronger or more persistent symptoms of dissociation around the time of the trauma is associated with a greater likelihood of later development of PTSD.

Common Features of Traumatic Stress Disorders

• PTSD presents with a similar symptom profile as acute stress disorder, but may persist for months, years, or even decades, and may not develop until many months or even years after the traumatic event.
• Although exposure to combat or terrorist attacks may be the types of trauma the public most strongly links to PTSD (Pitman, 2006), the traumatic experiences most commonly associated with PTSD are serious motor vehicle accidents (Blanchard & Hickling, 2004).

Theoretical Perspectives

The major conceptual understanding of PTSD derives from the behavioral or learning perspective.

• Within a classical conditioning framework, traumatic experiences are unconditioned stimuli that become paired with neutral (conditioned) stimuli such as the sights, sounds, and even smells associated with the trauma—for example, the battlefield or the neighborhood in which a person has been raped or assaulted.
• Consequently, anxiety becomes a conditioned response that is elicited by exposure to trauma-related stimuli.

Treatment Approaches

Cognitive-behavioral therapy has produced impressive results in treating PTSD.

• The basic treatment component is repeated exposure to cues and emotions associated with the trauma.
• In CBT, the person gradually re-experiences the anxiety associated with the traumatic event in a safe setting, thereby allowing extinction to take its course.
• Therapists may use a more intense form of exposure called prolonged exposure, in which the person repeatedly reexperiences the traumatic event in imagination or in real life without seeking to escape from the anxiety.
• Treatment with antidepressant drugs, such as sertraline (Zoloft) or paroxetine (Paxil), may help reduce the anxiety components of PTSD (Schneier et al., 2012).
• Eye movement desensitization and reprocessing (EMDR) – A controversial form of therapy for PTSD that involves eye tracking of a visual target while holding images of the traumatic experience in mind.
• Evidence from controlled studies demonstrates the therapeutic benefits of EMDR in treating PTSD.
• Researchers lack a compelling theoretical model explaining why rapid eye movements would relieve symptoms of PTSD.

References:
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McGraw-Hill.McGraw Hill Higher Education (2013), The McGraw Hill Companies, Inc.
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