Acute stress reaction, adjustment disorder

Acute stress disorder (ASD) (F43.0)

• Stressor: same as in PTSD (see PTSD for more information)
• can progress into PTSD, especially if left untreated
• according to the DSM-V there are various criteria that need to be met in order to diagnose it
  • Time: > 3 days but < 1 month (PTSD > 1 month)
  • Specific symptoms (at least 9 out of 14) in the category of intrusive thoughts, negative emotions, arousal, avoidance and dissociation
    • Intrusion: intrusive thoughts: flashbacks, intrusive thoughts (recollection of psychotraumatic events)
    • Negative effect on mood and cognition: distorted memories, negative thoughts or expectations, constant negative emotions
    • Dissociation
    • avoidance: e.g. not talking about it, not going to the place
    • arousal: irritability (not anxiety, angry outbursts), hypervigilance, sleep disturbance

Adjustment disorder (AD) (F43.2)

• Stressor
  • usually non-life threatening (not PTSD) → mood change (but not mood disorder), no grief → therefore a diagnosis of exclusion
• Examples
  • break-up (marriage, long relationship), children moving out of home, getting fired from the job
• Symptoms and Diagnostic criteria
  • mood or behavioral changes that do not fit the criteria of other mental disorders (e.g. Major depressive episode, dysthymia, general anxiety disorder)
  • reaction is disproprotionate to the expected response to the trigger (e.g. losing job)
  • occurs within 3 months of onset of the stress, lasting less than 6 months