Acute Stress Reaction

Question 1

Define acute stress reaction

Answer 1

Occurs in the first 4 weeks after a person has been exposed to a traumatic event (threatened death, serious injury, road traffic accident, sexual assault etc.)

Question 2

Differentiating acute stress reaction and adjustment disorder

Answer 2

Key difference between is that an acute stress reaction will typically follow a highly stressful event, whereas with adjustment disorder, the stressor need not be severe or outside the “normal” human experience

E.g. difference between seeing a fatal car accident vs being made redundant

Question 3

Clinical features of acute stress reaction

Answer 3

Intrusive thoughts e.g. flashbacks, nightmares

Dissociation e.g. ‘being in a daze’, time slowing

Negative mood

Avoidance

Arousal e.g. hyper-vigilance, sleep disturbance

Question 4

Management for acute stress reaction

Answer 4

Trauma-focussed CBT first line

Benzodiazepines for acute symptoms (agitation, sleep disturbance) but use with caution

Question 5

Define adjustment disorder

Answer 5

A state of emotional distress and disturbance usually interfering with social functioning arising in a period of adaptation to a significant life change or stressful life event such as bereavement or separation