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Acute Stress Disorder treatment: Does it really work?




Acute Stress Disorder Overview:



By definition, acute stress disorder is a result of a traumatic event in which the person experienced or witnessed an event that involved threatened or actual serious injury or death and responded with intense fear and helplessness. Thus, acute stress disorder treatment would generally be aimed at being brief, and would be provided as immediately as possible following the trauma. Individuals most in need of acute stress disorder treatment would include survivors with psychiatric disorders; traumatically bereaved people; children, especially those separated from their parents; and individuals who are especially dependent upon psychosocial support mechanisms, such as the elderly and handicapped and traumatized survivors.




Acute Stress Disorder: What does treatment entail?


The different components of acute stress disorder treatment involve providing psychosocial information, crisis intervention and emotional first aid.  Information should be provided about the trauma to allow the individual to fully recognize and accept all of the relevant details.  Obviously, information needs to be given in a way that conveys a sense of hope and the possibility that psychological pain and the threat of loss can be effectively cope with.  It is believed that psychological support may help to strengthen an individual's mechanisms for coping and perhaps facilitate their adaptive defense mechanisms. The survivors who benefit to the greatest degree possible are those who take full responsibility for the outcome and participate completely in the acute stress disorder treatment process.  Also, crisis intervention is frequently recommended shortly after natural disasters, serious traumas or acts of violence.  Some experts have recommended using what has been described as emotional first aid, which is used to achieve the following: acceptance of feelings, symptoms, reality, and the need for help; recognition of psychologically distressing issues; identification of available resources; acceptance of responsibility in absence of blame; cultivation of an optimistic attitude; and efforts to resume activities daily life as much as possible.


Trauma survivors with acute stress disorder have been found to engage in worry and cognitive strategies of punishment more than survivors without acute stress disorder.  Cognitive behavioral therapy has been found to reduce the strategies and increased the use of social control strategies and reappraisal.  However, at the present time, the relationship of these findings to the development of post-traumatic stress disorder has not yet been determined.


There has not been much investigation to determine if early acute stress disorder treatment has effectively reduced the onset of post-traumatic stress disorder, although it may be safe to assume that early treatment may have some preventative effect.  However, during World War II, rapid and effective treatment of acute combat stress did not always prevent veterans from developing chronic mental health problems.  Also, intervention designed recently to prevent the development of post-traumatic stress disorder which was administered in the acute phase, critical incident stress debriefing, has been found to be ineffective in preventing the development of post-traumatic stress disorder.  However, there has been a study with individuals involved in motor vehicle accidents that suggested that exposure therapy and exposure therapy with anxiety management training, may be effective in preventing post-traumatic stress disorder.  Obviously, it is important to note that an understanding of effective acute stress disorder treatment at the present time is in the early developmental stages.


Some information from the DSM-IV-TR Mental Disorders: Diagnosis, Etiology and Treatment by Michael B. First and Alan Tasman

 Webpage by Paul Susic Ph.D.  Licensed Psychologist   (Health and Geriatric Psychologist)

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