Stress and Trauma-Related Disorders

Post-Traumatic Stress Disorder (PTSD) has gained growing public interest since the US involvement in Afghanistan and Iraq brought home more soldiers suffering from PTSD and related emotional disorders. Interestingly, PTSD shares many characteristics with Acute Stress Disorder, and both can share some characteristics with Adjustment Disorder.

Adjustment Disorder, Acute Stress Disorder, and PTSD Characteristics

Adjustment Disorder forms as a response to some stressor or stressors that leads to the development of emotional or behavioral issues in the individual. This is often seen in children and the elderly, but it can occur at any age.

Additionally, Adjustment Disorder often occurs in individuals suffering from depression, anxiety, or both. It can also be seen occurring with conduct issues sometimes accompanied by emotional disturbance. These conduct issues may not be significant enough for a Conduct Disorder diagnosis, but can be demonstrated in vandalism, truancy, and fighting in children and adolescents, or perhaps reckless driving and defaulting on responsibilities in adults. There is also an "unspecified" type for those that do not fit into one of the other subtypes. Often, when the underlying issues are resolved (usually through cognitive-behavioral therapy) the Adjustment Disorder will seem to resolve on its own.

Acute Stress Disorder is widely regarded as a semi-precursor to Post-Traumatic Stress Disorder (PTSD). Relatively new to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-Tr), Acute Stress Disorder is characterized by the symptoms of PTSD but sometimes accompanied by severe dissociative symptoms such as amnesia for the traumatic event (whole or partial), emotional numbing, or feelings of unreality (derealization). These are typically observed immediately following the trauma.

Acute Stress Disorder is believed to be an indicator of the development of Post-Traumatic Stress Disorder later, but the addition of Acute Stress Disorder to the DSM-IV-Tr allows professionals to provide diagnosis and help or intervention sooner, within one month of the incident that provoked the onset.

Post-Traumatic Stress Disorder is typically diagnosed one or more months following the traumatic event. If diagnosed after one month, it receives the additional label of "acute" and if lasting longer than three months it can receive the additional label of "chronic." Some do not show any symptoms following the trauma, but symptoms present later. In these cases, the individual receives the label "PTSD with delayed onset."

Differences Between Adjustment Disorder, Acute Stress Disorder, and PTSD

Unlike PTSD, which cannot be diagnosed until one month following the incident, Acute Stress Disorder can be diagnosed immediately. While https://plus.google.com/+Kennylawassociates/posts?hl=en these two related disorders often involve traumatic incidents such as abuse, assault (e.g. mugging, rape), witnessing a crime (e.g. store robbery, murder), car accidents, and so forth, Adjustment Disorder can occur simply from the accumulation of stressors over time, and often involve a clearly identifiable major stressor that will trigger the onset of the problematic symptoms.

In children, the trigger incident can be the divorce of their parents, for example, or perhaps a major family move. In older patients, as seen in many case studies, it could be the "empty nest" situation that provokes the onset, or perhaps the death of a partner.

Cultural, Situational, and Age Factors in Diagnosis

These disorders are alike in that they can be observed in many age brackets and across cultures, with almost universal levels of distress even if the observable or reported symptoms vary due to cultural or age differences. Additionally, they all cause some marked level of distress in the individual and often a disturbance in their normal functioning. In all three disorders, the symptoms have to be clearly distinct from grief (bereavement), especially in cases of the loss of a loved one. The grieving period is different for everyone and should be considered before diagnosing PTSD, Acute Stress Disorder, Adjustment Disorder, or any other psychological condition.

References:

American Psychiatric Association (2000). Diagnostic and Statistical Manual for Mental Disorders (4th Ed.) Text Revision. Jaypee Medical Publishers.

Frances, A., Ross, R. (2001). DSM-IV-Tr Case Studies: A Clinical Guide to Differential Diagnosis. American Psychiatric Publishing.

Barlow, D., Durand, M. (2009). Abnormal Psychology: An Integrative Approach. Wadsworth, Cengage Learning.

http://suite101.com/stress-and-trauma-related-disorders-a250090