Acute stress reaction
Acute stress reaction is a transient disorder of considerable gravity which develops in an individual without any mental disorder as a result of extraordinary stress and which declines within several hours or days. In acute stress reaction the stressful factors represent an overpowering traumatic occurrence relating to severe menace to the safety or health of the individual. Stress in psychology and biology is understood as any tension or intervention that upsets the functioning of an organism. People react to physical and psychological stress by means of psychic and physiological defense mechanisms.
If the stress is very potent and at the same time the defense mechanisms are insufficient, it may lead to psychosomatic or mental disorders and acute stress reaction is one of such conditions. Acute stress reaction develops as a result of such factors as catastrophes, accidents, wars, criminal assault, and rape. Acute stress reaction may also develop after an unexpected and menacing alterations in life, such as death of loved person or fire. Acute stress reaction is also known under the names of acute crisis reaction, combat fatigue, crisis state, psychic shock. Doctors affirm that individual’s abilities in controlling stressful situations can have a significant influence upon his functional capacity and response to extremal conditions.
Symptoms
The symptoms appear within minutes after the influence of the stressful factor, and disappear within 2-3 days. The symptoms of acute stress reaction include the incipient state of stupefaction with considerable limitation of consciousness and reduction of attention, failure to understand and interpret signals, and confusion. This condition may be accompanied by dissociative stupor or by agitation and overactivity in the form of flight reaction. Vegetative signs of panic attacks and panic symptoms such as tachycardia, sweating, and reddening of skin are frequently observed.
There is an instantaneous and obvious temporal association between the action of an exceptional stressor and the beginning of symptoms. The symptoms demonstrate a mixed and changing picture such as depression, anxiety and panic, anger, despair, overactivity. The symptoms disappear quickly within a few hours in the cases where removal from the stressful situation is possible.
Two groups of symptoms are distinguished:
There should be at least four of 22 symptoms of anxiety, and one of them vegetative one.
The second group of symptoms includes:
- Escape from forthcoming social interactions.
- Narrowing of attention.
- Desorientation.
- Anger or verbal aggression.
- Despair or hopelessness.
- Inadequate or aimless hyperactivity.
- Uncontrollable and excessive feeling of grief considered according to local cultural standards.
If stressor is transient or can be facilitated, symptoms should start to decrease no more than in eight hours. If stressor continues to operate, symptoms should start to decrease no more than in 48 hours.
Differential diagnosis
Reaction should develop in absence of any other mental or behavioral disorder with the exception of generalized anxiety disorder and disorder of the personality and no less than in three months after the end of an episode of any other mental or behavioral disorder.
Variants:
According to the degree of gravity the acute stress reaction is subdivided as:
Easy — only the criterion 1is is fulfilled;
Moderate — the criterion 1 is fulfilled and there are any of two symptoms of criterion 2;
Serious — the criterion 1 is fulfilled and there are any of 4 symptoms of criterion 2; or there is a dissociative stupor.