Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-ttngx Total loading time: 0 Render date: 2024-05-02T16:56:02.052Z Has data issue: false hasContentIssue false

7 - Acute stress disorder and post-traumatic stress disorder in the disaster environment

from Part III - Clinical care and interventions

Published online by Cambridge University Press:  09 August 2009

By
David M. Benedek
Edited by
Robert J. Ursano ,
Carol S. Fullerton ,
Lars Weisaeth  and
Beverley Raphael
David M. Benedek
Affiliation:
Associate Professor Center for the Study of Traumatic Stress
Robert J. Ursano
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Carol S. Fullerton
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Lars Weisaeth
Affiliation:
Universitetet i Oslo
Beverley Raphael
Affiliation:
University of Western Sydney
Get access

Summary

Introduction

Post-traumatic stress disorder (PTSD) is an often severe, chronic, and disabling mental disorder that may develop after exposure to a traumatic event (or events) as may occur in disasters. Acute stress disorder (ASD) is characterized by similar – but transient – symptoms. Given their potential to result in widespread distress and dysfunction, PTSD and ASD deserve special consideration in disaster preparedness and response plans.

Beyond duration of symptoms, ASD is distinguished from PTSD by a diagnostic requirement for symptoms of peritraumatic dissociation. While ASD does not inevitably portend the later development of PTSD, dissociation may be the best predictor of the subsequent development of PTSD (Harvey & Bryant, 1998). Both PTSD and ASD are characterized by specific symptoms organized into core clusters of re-experience, hyperarousal, and avoidance/numbing. The common and distinguishing characteristics of the two disorders are described in the following section of this chapter, “Clinical presentation.” Since other mental disorders (e.g., depression, substance abuse), stress reactions, and both acute and chronic distress-related behavioral changes not amounting to diagnosable disorders contribute greatly to the public health burden of disaster and often co-occur, the differential diagnosis and features associated with ASD and PTSD are also reviewed.

The atmosphere of chaos, disruption, unanticipated injury, loss, and death created by any disaster will establish a population meeting the traumatic exposure threshold criterion necessary – but not sufficient – for the development of ASD or PTSD. The section of this chapter entitled “Epidemiology” highlights the idea that many individuals exposed to significant trauma do not develop ASD or PTSD and describes subgroups that may be at greater risk for these conditions in the aftermath of disaster.

Keywords

acute stress disorderclinical interviewcognitive-behavioral therapydisasterselective serotonin reuptake inhibitorsneurobiological mechanismsPTSD
Type
Chapter
Information
Textbook of Disaster Psychiatry , pp. 140 - 163
Publisher: Cambridge University Press
Print publication year: 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., revision. Arlington, Va.: American Psychiatric Press
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn., text revision. Arlington, Va.: American Psychiatric Press.
American Psychiatric Association (2004). Practice guidelines for the treatment of patients with acute stress disorder and post traumatic stress disorder. American Journal of Psychiatry, Suppl, 161(11).
Barry, L. C., Kasl, S. V. & Prigerson, H. G. (2001). Psychiatric disorders among bereaved persons: the role of perceived circumstances of death and preparedness for death. American Journal of Geriatric Psychiatry, 10, 447–457.Google Scholar
Benedikt, R. A. & Kolb, L. C. (1986). Preliminary findings on chronic pain and posttraumatic stress disorder. American Journal of Psychiatry, 143, 908–910.Google Scholar
Blake, D. D., Weathers, F. W., Nagy, L. M.et al. (1990). A clinician rating scale for current and lifetime PTSD: the CAPS-1. Behavior Therapist, 18, 187–188.Google Scholar
Breslau, N. (2002). Gender differences in trauma and post traumatic stress disorder. Journal of Gender Specific Medicine, 5, 34–40.Google Scholar
Breslau, N., Davis, G. C, Andreski, P. & Peterson, E. (1991). Traumatic events and posttraumatic stress disorder in an urban population of young adults. Archives of General Psychiatry, 48, 216–222.Google Scholar
Breslau, N., Kessler, R. C., Chilcoat, H. D.et al. (1998). Trauma and posttraumatic stress disorder in the community: the 1996 Detroit area survey of trauma. Archives of General Psychiatry, 55, 626–632.Google Scholar
Brewin, C. R., Andrews, B. & Valentine, J. D. (2000). Meta-analysis of risk factors for post-traumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748–766.Google Scholar
Bromet, E., Sonnega, A. & Kessler, R. C. (1998). Risk factors for DSM-III-R posttraumatic stress disorder: findings from the national comorbidity survey. American Journal of Epidemiology, 147, 353–361.Google Scholar
Bryant, R. A. (2005). Psychosocial approaches to acute stress reactions. CNS Spectrums, 10, 116–122.Google Scholar
Bryant, R. A. & Harvey, A. G. (2000). Acute Stress Disorder: A Handbook of Theory, Assessment and Treatment. Washington, D.C.: American Psychological Association.
Bryant, R. A., Moulds, M. L. & Guthrie, R. M. (2000). Acute stress disorder scale: a self-report measure of acute stress disorder. Psychologic Assessment, 12, 61–68.Google Scholar
Charney, D. S. (2002). Update on treatment of anxiety disorders. Journal of Clinical Psychiatry CNS Discourses, 2, 1–4.Google Scholar
Charney, D. S. (2004). Psychobiological mechanisms or resilience and vulnerability: implications for successful adaptation to extreme stress. American Journal of Psychiatry, 161, 194–216.Google Scholar
Connor, K. M. & Butterfield, M. I. (2003). Posttraumatic stress disorder. FOCUS, I, 247–262.Google Scholar
Davidson, J. R., Hughes, D., Blazer, D. G. & George, L. K. (1991). Post-traumatic stress disorder in the community: an epidemiological study. Psychological Medicine, 21, 713–721.Google Scholar
Davidson, J. R. T., Book, S. W., Colket, J. T.et al. (1997). Assessment of a new self-rating scale of post-traumatic stress disorder. Psychological Medicine, 27, 153–160.Google Scholar
Davidson, P. R. & Parker, K. C. (2001). Eye movement desensitization and reprocessing (EMDR): a meta-analysis. Journal of Consulting and Clinical Psychology, 69, 305–316.Google Scholar
Delahanty, D. L., Raimonde, J. & Spoonster, E. (2000). Initial post-traumatic urinary cortisol levels predict subsequent symptoms in motor vehicle accident victims. Biological Psychiatry, 48, 940–947.Google Scholar
Drossman, D. A. (1995). Sexual and physical abuse and gastrointestinal illness. Scandinavian Journal of Gastroenterology, 30 (Suppl 208), 90–96.Google Scholar
First, M. B., Spitzer, R. L., Gibbon, M. & Williams, J. B. (1995). Structured Clinical Interview for DSM–IV Axis I Disorders-Patient Edition (SCID I/P Version 2). New York: Biometrics Research Department, New York State Psychiatric Institute.
Foa, E. B. & Tolin, D. F. (2000). A comparison of the PTSD symptom scale interview and the clinician-administered PTSD scale. Journal of Traumatic Stress, 13, 181–191.Google Scholar
Foa, E. B., Riggs, D. S., Dancu, C. B. & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459–473.Google Scholar
Galea, S., Ahern, J., Resnick, H.et al. (2002). Psychological sequelae of the September 11th terrorist attacks in New York City. New England Journal of Medicine, 346, 982–987.Google Scholar
Galea, S., Boscarino, J., Resick, H. & Vlahov, D. (2003a). Mental Health in New York City after the September 11th terrorist attacks: results from two populations surveys. In Mental Health, United States, 2002, eds. Mandersheid, R. W. & Henderson, M. J.. Washington, D.C.: US Government Printing Office.
Galea, S., Vlahov, D., Resick, H.et al. (2003b). Trends of probable post-traumatic stress disorder in New York City after the September 11th terrorist attacks. American Journal of Epidemiology, 158, 514–524.Google Scholar
Grieger, A., Cozza, S. J., Ursano, R. J.et al. (2006). Posttraumatic stress disorder and depression in battle-injured soldiers. American Journal of Psychiatry, 163, 1777–1783.Google Scholar
Harvey, A. G. & Bryant, R. A. (1998). The relationship between acute stress disorder and posttraumatic stress disorder: a prospective evaluation of motor vehicle accident survivors. Journal of Consulting and Clinical Psychology, 66, 507–512.Google Scholar
Helzer, J. E., Robins, L. N. & McEvoy, L. (1987). Posttraumatic stress disorder in the general population: findings of the Epidemiological Catchment Survey. New England Journal of Medicine, 317, 1630–1634.Google Scholar
Hembree, E. A. & Foa, E. B. (2000). Posttraumatic stress disorder: psychological factors and psychosocial interventions. Journal of Clinical Psychiatry, 61 (Suppl 7), 33–39.Google Scholar
Horowitz, M. J. (1976). Stress Response Syndromes. New York: Jason Aronson.
Horowitz, M. J., Siegel, B., Holen, A.et al. (1997). Diagnostic criteria for complicated grief disorder. American Journal of Psychiatry, 154, 904–910.Google Scholar
Jordan, B. K., Schlenger, W. E., Hough, R.et al. (1991). Lifetime and current prevalence of specific psychiatric disorders among Vietnam veterans and controls. Archives of General Psychiatry, 48, 207–215.Google Scholar
Keane, T. M. & Wolf, J. (1990). Comorbidity in posttraumatic stress disorder: an analysis of community and clinical studies. Journal of Applied Social Psychology, 20, 1776–1778.Google Scholar
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M. & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 1048–1060.Google Scholar
Kulka, R. A., Schlenger, W. E., Fairbank, J. A.et al. (1990). Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study. New York: Brunner/Mazel.
McFarlane, A. C. (1998). Epidemiological evidence about the relationship between PTSD and alcohol abuse: the nature of the association. Addictive Behaviors, 23, 813–825.Google Scholar
McFarlane, A. C., Yehuda, R. & Clark, C. R. (2002). Biologic models of traumatic memories and post-traumatic stress disorder: the role of neural networks. Psychiatric Clinics of North America, 25, 253–270.Google Scholar
Mellman, L. (1998). Consequences of violence against women. In: Women's Health: A Lifelong Guide. New York: Scientific American Digital.
Nisenbaum, L. K. & Abercrombie, E. D. (1993). Presynaptic alterations associated with enhancement of evoked release and synthesis of norepinephrine in hippocampus of chronically cold-stressed rats. Brain Research, 608, 280–287.Google Scholar
Norris, F. H. (1992). Epidemiology of trauma: frequency and impact of different potentially traumatic events on different demographic groups. Journal of Consulting and Clinical Psychology, 60, 409–418.Google Scholar
North, C. S., Nixon, S. J., Shariat, S.et al. (1999). Psychiatric disorders among survivors of the Oklahoma City Bombing. Journal of the American Medical Association, 282, 755–762.Google Scholar
Pitman, R. K. & Delahanty, D. L. (2005). Conceptually driven pharmacologic approaches to acute trauma. CNS Spectrums, 10, 99–106.Google Scholar
Pitman, R. K., Shalev, A. Y. & Orr, S. P. (2000). Posttraumatic stress disorder: emotion, conditioning and memory. In The New Cognitive Neuroscience, 2nd edn., eds. Corbetta, M. D. & Gazzaniga, M., pp. 1133–1147. New York: Plenum Press.
Prigerson, H. G. (2004). Complicated grief: when the path of adjustment leads to a dead-end. Bereavement Care, 23, 38–40.Google Scholar
Prigerson, H. G., Bierhals, A. J., Kasl, S. V.et al. (1996). Complicated grief as a disorder distinct from bereavement-related depression and anxiety: a replication study. American Journal of Psychiatry, 153, 1484–1486.Google Scholar
Prigerson, H. G., Shear, M. K., Jacobs, S. C.et al. (1999). Consensus criteria for traumatic grief: a preliminary empirical test. British Journal of Psychiatry, 174, 67–73.Google Scholar
Raskind, M. A., Peskind, E. R., Kanter, E. D.et al. (2003). Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study. American Journal of Psychiatry, 160, 371–373.Google Scholar
Rauch, S. L., Kolk, B. A., Fisler, R. E.et al. (1996). A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script-driven imagery. Archives of General Psychiatry, 53, 380–387.Google Scholar
Resick, P. A., Nishith, P., Weaver, T. L., Astin, M. C. & Feuer, C. A. (2002). A comparison of cognitive processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology, 70, 867–879.Google Scholar
Resnick, H. S., Kilpatrick, D. G., Dansky, B. S., Saunders, B. E. & Best, C. L. (1993). Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of Consulting and Clinical Psychology, 61, 984–991.Google Scholar
Rothbaum, B. O., Foa, E. B., Murdock, T. & Walsh, W. (1992). A prospective examination of post-traumatic stress disorder in rape victims. Journal of Traumatic Stress, 5, 455–475.Google Scholar
Salmon, P. & Calderbank, S. (1996). The relationship of childhood physical and sexual abuse to adult illness behavior. Journal of Psychosomatic Research, 40, 329–336.Google Scholar
Shalev, A. Y. (2002). Acute stress reactions in adults. Biological Psychiatry, 181, 158–162.Google Scholar
Shalev, A. Y., Sahar, T., Freedman, S.et al. (1998). A prospective study of heart rate response following trauma and the subsequent development of posttraumatic stress disorder. Archives of General Psychiatry, 55, 553–559.Google Scholar
Shear, M. K., Zuckoff, A. & Frank, E. (2001). The syndrome of traumatic grief. CNS Spectrums, 6, 336–346.Google Scholar
Solomon, E. P. & Heide, K. M. (2005). The biology of trauma: implications for treatment. Journal of Interpersonal Violence, 20, 51–60.Google Scholar
Southwick, S. M., Bremner, J. D., Rasmusson, A.et al. (1999). Role of norepinephrine in the pathophysiology and treatment of posttraumatic stress disorder. Biological Psychiatry, 46, 1192–1204.Google Scholar
Stein, M. B., Walker, J. R., Hazen, A. L. & Forde, D. R. (1997). Full and partial posttraumatic stress disorder: findings from a community survey. American Journal of Psychiatry, 154, 1114–1119.Google Scholar
Ursano, R. J., Fullerton, C. S., Epstein, R. S.et al. (1999). Acute and chronic posttraumatic stress disorder in motor vehicle accidents. American Journal of Psychiatry, 156, 589–595.Google Scholar
Kolk, B. A. (1997). The psychobiology of posttraumatic stress disorder. Journal of Clinical Psychiatry, 58 (Suppl 9), 16–24.Google Scholar
Vlahov, D., Galea, S., Resnick, H.et al. (2002). Increased use of cigarettes, alcohol, and marijuana among Manhattan, New York residents after the September 11th terrorist attacks. American Journal of Epidemiology, 155, 988–996.Google Scholar
Watson, P. & Shalev, A. (2005). Assessment and treatment of adualt acute response to traumatic stress. CNS Spectrums, 10 (2), 96–98.Google Scholar
Zatzick, D. (2003). Posttraumatic stress, functional impairment and service utilization after injury: a public health approach. Seminars in Clinical Neuropsychiatry, 8, 149–157.Google Scholar
Zlotnick, C., Franklin, C. L. & Zimmerman, M. (2002). Does “subthreshold” posttraumatic stress disorder have any clinical relevance? Comprehensive Psychiatry, 43, 413–419.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×