TRAUMA AND STRESSOR RELATED DISORDER
Trauma- and stressor-related disorders is a category in DSM-5 that includes conditions like acute stress disorder, PTSD, reactive attachment disorder, disinhibited social engagement disorder (DSED), and adjustment disorders. These disorders arise from experiencing traumatic or stressful events as defined in the diagnostic criteria.
POST TRAUMATIC STRESS DISORDER
Many people often feel intense fear after experiencing traumatic events like war, accidents, natural disasters, or violence. While most individuals will naturally recover from their distress over time, some may face ongoing mental health challenges, including PTSD, depression, anxiety, or substance use issues that can last for months or even years.
It’s normal to feel distress after such events, but it’s important to note that this doesn’t always mean someone has PTSD. PTSD is specifically diagnosed when a person has symptoms like re-experiencing the trauma, avoiding reminders of it, and experiencing heightened arousal, which significantly impacts daily life, relationships, and work.
Symptoms:
Intrusion:
- Repeated, unwanted memories.
- Nightmares.
- Vivid flashbacks of the trauma.
Avoidance:
- Steering clear of reminders related to the trauma, such as people, places, and activities.
- Avoiding thoughts about the trauma.
- Not wanting to discuss your feelings or the event.
Changes in Thinking and Mood:
- Persistent feelings of fear, anger, guilt, or shame.
- Forgetting key details about the trauma.
- Negative thoughts and feelings about yourself and others.
- Misplaced blame regarding the cause or outcomes of the event.
- Feeling disconnected from others.
- Losing interest in activities you once enjoyed.
- Difficulty feeling positive emotions.
Changes in Arousal and Reactivity:
- Increased irritability and anger.
- Engaging in reckless or harmful behavior.
- Heightened awareness of your surroundings (hypervigilance).
- Being easily startled.
- Struggling to concentrate or sleep.
Symptoms of PTSD in Children:
- Children may find it hard to express their feelings or may have experienced unknown trauma. They might seem restless, fidgety, or struggle with focus and organization.
Diagnostic Criteria:
Exposure to Traumatic Event
Exposure to actual or threatened death, serious injury, or violence.
Criteria for Exposure
- Directly experiencing the traumatic event(s).
- Witnessing, in person, the event(s) as it occurred to others.
- Learning that the traumatic event(s) occurred to a close family member or close friend.
- Experiencing repeated or extreme exposure to aversive details of the traumatic event(s).
ACUTE STRESS DISORDER
Acute stress disorder is a strong and disturbing reaction that happens shortly after experiencing a traumatic event, lasting for less than a month. If symptoms continue beyond a month, it can develop into posttraumatic stress disorder (PTSD).
Individuals with acute stress disorder often experience heightened anxiety, flashbacks of the trauma, avoidance of reminders related to the event, negative feelings, and increased arousal. They might also feel emotionally numb or disconnected from reality, experiencing symptoms like derealization or amnesia.
Symptoms:
- Recurring and distressing memories of the event.
- Frequent nightmares.
- Sudden flashbacks of the trauma.
- Intense anxiety or physical discomfort when reminded of the event.
- Ongoing struggle to feel positive emotions, like happiness or love.
- A distorted sense of reality, often feeling dazed or like time is dragging.
- Forgetting key details about the traumatic experience.
- Trying to avoid distressing thoughts and feelings about the event.
- Steering clear of people, places, or things that remind you of the trauma.
- Trouble sleeping.
- Increased irritability or anger outbursts.
- Heightened awareness of potential dangers (hypervigilance).
- Difficulty focusing.
- Strong reactions to loud noises or sudden movements (startle response).
Diagnostic Criteria:
Exposure to Traumatic Event
Exposure to actual or threatened death, serious injury, or violence.
Criteria for Exposure
- Directly experiencing the traumatic event(s).
- Witnessing, in person, the event(s) as it occurred to others.
- Learning that the traumatic event(s) occurred to a close family member or close friend.
- Experiencing repeated or extreme exposure to aversive details of the traumatic event(s).
ADJUSTMENT DISORDER
Adjustment disorder is a term used to describe a strong emotional reaction to a stressful situation. It often involves feelings of distress and emotional turmoil that arise when someone is trying to cope with major life changes, stressful events, serious health issues, or the fear of serious illness. While stress is a normal part of life and we usually learn to manage it over time, sometimes our usual coping strategies aren’t enough. This is when adjustment disorder can develop.
Symptoms:
- Feeling sad or hopeless, and losing interest in things you used to enjoy.
- Crying frequently.
- Experiencing anxiety, stress, or nervousness.
- Feeling irritable or overwhelmed by daily tasks.
- Trouble sleeping.
- Not eating enough.
- Difficulty concentrating.
- Struggling with everyday activities.
- Isolating yourself from supportive friends and family.
- Neglecting important responsibilities, like work or bills.
- Having thoughts of self-harm or suicide.
Diagnostic Criteria:
- The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).
- These symptoms or behaviors are clinically significant, as evidenced by one or both of the following:
- Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation.
- Significant impairment in social, occupational, or other important areas of functioning.
- The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a preexisting mental disorder.
- The symptoms do not represent normal bereavement.
- Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional 6 months.