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Query: UMLS:C0848237 (acute stress)
 4,619 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Traumatic events are incidents that lie outside the range of usual human experience and are so powerful that they are capable of overwhelming any person's normal coping abilities and causing severe stress reactions. Traumatic event debriefing (TED), conducted 24 to 72 hours after exposure to the traumatic event, uses a form of intensive group crisis intervention. The method is designed to help reduce acute stress symptoms and accelerate the recovery process, thereby diminishing the subsequent development of posttraumatic stress disorder. Social workers have the precise constellation of skills, social-environmental perspectives, and practice methodologies indispensable both to developing TED teams and to leading the debriefings. This article addresses the evolution of debriefing-type psychological interventions for trauma victims, the debriefing process itself, three environment-specific debriefing team designs, and the unique qualifications of social workers to develop and lead the teams.
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PMID:Traumatic event debriefing: service delivery designs and the role of social work. 786 71

Although it is not yet clear that striking gains can be made toward the goal of preventing the development of post-traumatic stress disorder (PTSD) through early treatment, an initial step has been made by identification of a new category of disorder in DSM-IV, the acute stress disorder. Evidence exists that, at the least, it is possible to have a significant effect on the symptomatology generated by acute stress through the use of culturally endorsed rituals, psychological methods such as support and formal crisis intervention, focused psychotherapy, and psychopharmacology. Whether success on this front will ultimately affect the incidence and development of PTSD remains to be seen.
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PMID:The treatment of acute trauma. Post-traumatic stress disorder prevention. 793 65

The stress associated with experiencing or witnessing physical trauma can cause abrupt and marked alterations in mental state, including anxiety and transient dissociative symptoms. Intense manifestations of this pattern of response to trauma are described in a new diagnostic category proposed for DSM-IV: acute stress disorder. Severe dissociative symptoms may predict subsequent posttraumatic stress disorder. Persons who experience a series of traumatic events may be especially vulnerable to a variety of dissociative states, including amnesia, fugue, depersonalization, and multiple personality disorder. Treatment for these symptoms emphasizes strengthening supportive interpersonal relationships and developing insight that reduces psychological pain by integrating the trauma into a meaningful, less self-blaming perspective.
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PMID:Trauma and dissociation. 850 55

In a representative national survey, general practitioners and psychiatrists were asked about their experience and knowledge with regard to psychological sequelae of traumatic life events. A questionnaire addressing 10 traumatic stress related issues was mailed to every fifth general practitioner and psychiatrist in private practice in Switzerland (N = 1284). The return rate was 37%. Every second doctor reported having experiences in treating posttraumatic disorders. Sexual abuse and accidents were the mostly mentioned traumas. General practitioners are frequently confronted with acute stress disorders, while psychiatrists more often have to deal with PTSD. Psychiatrists knew more about specific treatment possibilities than general practitioners. Only a minority was satisfied with the existing therapeutic services for trauma victims. Few doctors (more psychiatrists than GPs) had plans for further education. A majority suggested interdisciplinary treatment approaches. When planning further education, preference should be given to interdisciplinary approaches, taking into consideration at the same time the specific needs of different professional groups.
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PMID:[Psychotraumatology in medical practice--a survey]. 892 35

From August to November 1992, five typhoons struck the U.S. Pacific island territory of Guam. Three hundred and twenty subjects exposed to all five typhoons participated in a population survey measuring their acute stress symptoms and subsequent diagnoses of posttraumatic stress disorder (PTSD) and depression. A 23-item scale approximating the new DSM-IV diagnosis of acute stress disorder (ASD) was used to classify subjects into three groups based on their symptoms one week after the first typhoon: (1) probable ASD, (2) an early traumatic stress response (ETSR) of fear, intrusion, avoidance, and arousal, without dissociation, and (3) no acute diagnosis. A multi-dimensional measure of PTSD and the Zung Self-Rating Depression Scale were used to assess PTSD and depression 8 months after the first storm. The point prevalence of ASD at one week was 7.2%. An additional 15% of subjects had ETSR. Subjects with probable ASD at one week had significantly increased rates of PTSD and somewhat higher rates of depression at 8 months than those without ASD. In contrast, subjects with ETSR at one week did not have a poorer outcome than those with no acute diagnosis. These findings suggest that ASD is prognostically important, but also indicate that all acute stress symptoms do not have the same discriminative value. In this study, the acute dissociative symptoms of emotional numbing and derealization differentiated highly symptomatic subjects at risk for subsequent psychopathology (ASD) from others who were highly symptomatic at one week, but then had a more benign, posttraumatic course (ETSR).
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PMID:Acute stress disorder, subsequent posttraumatic stress disorder and depression after a series of typhoons. 916 Jun 26

Surgery is a stressful event, with the potential for profound disturbance to the patient's psychological and physiologic homeostasis. Cosmetic surgery is a particularly intense psychological experience because, in addition to the usual concerns about surgical side effects, cosmetic patients bring their hopes and expectations for improved self-image, putting them at risk for the added anxiety of disappointment. High levels of anxiety coupled with the perception of vulnerability or threat to self can cause significant psychological reactions complicating care for the plastic surgical patient. This paper outlines the diagnostic features of the common types of anxiety disorders seen in plastic surgical patients, and it offers treatment strategies for the practitioner, delineating when referral to a mental health expert is advised. Specific clinical case studies of panic attack, posttraumatic stress disorder, and acute stress disorder are presented to illustrate the variety of abnormal anxiety responses that may be encountered in the perioperative setting. Interventions for the anxious patient are part science and part art. Careful questioning and psychosocial assessment can identify those patients who are at greater risk for psychological problems after surgery. However, some patients may mask or keep secret their concerns, which can be manifested with resulting anger and hostility. Plastic surgeons must use appropriate indicators of psychological anxiety and measure a specific patient's reactions to surgery to make the diagnosis of abnormal anxiety. Close follow-up by the plastic surgical team is an essential part of the anxiety disorder patient's psychological treatment, but it is imperative that these problematic patients be referred promptly to a qualified mental health professional to limit their adverse experience and promote their well-being. Patients who are less anxious during the perioperative period report less emotional distress and fewer defensive behaviors and are likely to be more satisfied with the outcome of their surgery.
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PMID:Anxiety disorders in plastic surgery. 925 30

A study was undertaken to determine if female survivors of childhood and/or adolescent sexual abuse (CSA) would exhibit hypothalamic-pituitary-adrenal (HPA) axis abnormalities characteristic of patients with combat-related posttraumatic stress disorder (PTSD)--i.e., enhanced cortisol suppression to low-dose dexamethasone and increased density of lymphocyte glucocorticoid receptors. Nineteen women who reported experiencing severe CSA and 21 nonvictimized women participated in a low-dose (0.5 mg) dexamethasone suppression test and donated blood for measurement of lymphocyte glucocorticoid receptor binding. Women with CSA had significantly enhanced suppression of plasma cortisol in response to 0.5 mg dexamethasone compared to the nonvictimized women. These observations are consistent with findings in male veterans with combat-related PTSD. They suggest that this pattern of HPA axis dysfunction may be a characteristic sequel of psychiatric disorders that occur following a range of traumatic experiences. This HPA axis profile is different than that associated with acute stress or with major depressive disorder.
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PMID:Enhanced dexamethasone suppression of plasma cortisol in adult women traumatized by childhood sexual abuse. 932 61

Acute traumatic stress may lead to post-traumatic stress disorder (PTSD), which is characterized by delayed neuropsychiatric symptoms including depression, irritability, and impaired cognitive performance. Curiously, inhibitors of the acetylcholine-hydrolysing enzyme acetylcholinesterase may induce psychopathologies that are reminiscent of PTSD. It is unknown how a single stressful event mediates long-term neuronal plasticity. Moreover, no mechanism has been proposed to explain the convergent neuropsychological outcomes of stress and of acetylcholinesterase inhibition. However, acute stress elicits a transient increase in the amounts released of the neurotransmitter acetylcholine and a phase of enhanced neuronal excitability. Inhibitors of acetylcholinesterase also promote enhanced electrical brain activity, presumably by increasing the survival of acetylcholine at the synapse. Here we report that there is similar bidirectional modulation of genes that regulate acetylcholine availability after stress and blockade of acetylcholinesterase. These calcium-dependent changes in gene expression coincide with phases of rapid enhancement and delayed depression of neuronal excitability. Both of these phases are mediated by muscarinic acetylcholine receptors. Our results suggest a model in which robust cholinergic stimulation triggers rapid induction of the gene encoding the transcription factor c-Fos. This protein then mediates selective regulatory effects on the long-lasting activities of genes involved in acetylcholine metabolism.
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PMID:Acute stress facilitates long-lasting changes in cholinergic gene expression. 2660 28

Survivors of motor vehicle accidents with acute stress disorder (ASD) or with no ASD participated in a study on autobiographical memory within a week of their trauma. In Experiment 1, participants were provided cue words to elicit autobiographical memories of both an unconstrained time period and their trauma. Participants with ASD reported fewer specific memories to positive cue words than did non-ASD participants, even when the influence of depression was controlled. In Experiment 2, the same participants were assessed for posttraumatic stress disorder (PTSD) 6 months posttrauma. Poor recall of specific memories of the trauma in Experiment 1 accounted for 25% of the variance of PTSD severity. Accessibility of trauma memories in the acute posttrauma phase may have significant implications for longer term adjustment.
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PMID:Autobiographical memory in acute stress disorder. 964 88

Motor vehicle accident survivors (n = 92) were assessed for acute stress disorder (ASD) within 1 month of the trauma and reassessed (n = 71) for posttraumatic stress disorder (PTSD) 6 months posttrauma. ASD was diagnosed in 13% of participants, and a further 21% had subclinical levels of ASD. At follow-up, 78% of ASD participants and 60% of subclinical ASD participants met criteria for PTSD. The strong predictive power of acute numbing, depersonalization, a sense of relieving the trauma, and motor restlessness, in contrast to the low to moderate predictive power of other symptoms, indicates that only a subset of ASD symptoms is strongly related to the development of chronic PTSD. Although these findings support the use of the ASD diagnosis, they suggest that the dissociative and arousal clusters may require revision.
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PMID:The relationship between acute stress disorder and posttraumatic stress disorder: a prospective evaluation of motor vehicle accident survivors. 964 89


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