Acute Stress Disorder

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The stigma, misconceptions, and "tough it out" atttitude torwards trauma-related disorders has inspired the development of this document/digital zine, and why the first issue of Modern Minds has been dedicated to concepts relating to PTSD. I hope through the dissemination of this free magazine to broaden the definition of & destigmatize trauma-related 'disorders', encourage others to think critically & promote self-care wherby being kind to ourselves helps us to be kind to all.

Twenty-six million legal abortions occur each year worldwide. Of these an unknown
percentage of women have adverse psychological sequelae. This article reports on
interviews with a nonrandom sample of fifty women regarding reproductive history,
abortion experiences and emotional responses in the former Soviet Union country of
Belarus, where abortions are often used as a primary form of birth control. Both
positive and negative responses were queried but emphasis was on cross-cultural
comparisons with western samples regarding posttraumatic sequelae, depression, grief
and guilt, and using an objective measure of trauma symptoms, the IES-R.
Comparisons with existing Western literature allowed the question of: Similar to the
cross-cultural concept of posttraumatic stress disorder are their possibly universal
responses to abortion as well? As in western samples, attachment and recognition of
life during pregnancy were present for many women despite choosing abortion, and
eighty-two percent of the sample reported posttraumatic sequelae, which is high. Grief,
guilt, dissociation, depression, anxiety and psychosomatic responses were also in
common across cultures. The authors conclude that despite disparate circumstances
and abortion use, women who have adverse responses are very similar across these two
divergent cultures. They call for more research using representative samples to learn
what percentage of women are likely to have adverse responses and which variables
predict negative responses.

Although there has been a marked increase in research on psychological disorders following physical injury in recent years, there are many discrepancies between the reported findings. This paper reviews the prevalence outcomes of recent studies of the mental health sequelae of physical injury with a focus on posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and depression. The review critically outlines some of the methodological factors that may have contributed to these discrepancies. The phenomenological overlap between organic and psychogenic symptoms, the use of narcotic analgesia, the role of brain injury, the timing and content of assessments, and litigation are discussed in terms of their potential to confound findings with this population. Recommendations are proposed to clarify methodological approaches in this area. It is suggested that a clearer understanding of the psychological effects of physical injury will require the widespread adoption of more rigorous, standardized and transparent methodological procedures.

Abstract
The aim of this paper is to initiate a comparative and theoretical study between the mechanisms of cognitive behavioral intervention (CBI) versus art therapy, in relation to the acute stress disorder (ASD) stage of trauma. The literature on CBI, art therapy, and ASD will be briefly reviewed. Similarities between these two theoretically disparate interventions will be outlined, pointing to the relevance of CBI and art therapy to alter maladaptive and traumatic sensory processing, affect excitatory reactions, modulate and challenge explicit traumatic memories and stimulate a subsequent cognitive process. Implications for mental health professionals intervening in the relatively flexible ASD period are discussed.
Keywords

Aucune intervention thérapeutique n'est exempte de risque. La difficulté de la prise en charge aigue du patient traumatisé est au centre de nombreux débats. Malgré des synthèses de consensus d’experts, le type d'intervention thérapeutique après l'événement traumatique reste encore très controversé. L’état de stress en réaction immédiate est une manifestation comportementale et psychique nécessitant une prise en charge en urgence. Aujourd'hui, un objectif différent est recherché par ce premier contact avec le traumatisé psychique. Au-delà de dispenser un soin et de l'aider au dépassement de la situation aiguë, l’intervenant portera aussi un regard de dépistage des éléments prédictifs d’une évolution vers un état de stress post traumatique (ESPT).

Title: The hypnosis and the posttraumatic disorders. Abstract: The statistics show that the majority of us will experience at least one traumatic event during our lifetime, although only a minority will develop posttraumatic condi- tions (e.g., acute stress disorder or posttraumatic stress dis- order). Hypnosis for the treatment of posttraumatic condi- tions has a long and venerable history. Its techniques

Facial injuries are widely assumed to lead to stigma and significant psychosocial burden. Experimental studies of face perception support this idea, but there is very little empirical evidence to guide treatment. This study sought to address the gap.
Data were collected from 193 patients admitted to hospital following facial or other trauma. Ninety (90) participants were successfully followed up eight months later. Participants completed measures of appearance concern and psychological distress (post-traumatic stress symptoms, depressive symptoms, anxiety symptoms). Participants were classified by site of injury (facial or non-facial injury).
Overall levels of appearance concern were comparable to those of the general population, and there was no evidence of more appearance concern among people with facial injuries. Women and younger people were significantly more likely to experience appearance concern at baseline. Baseline and Eight month psychological distress, although common in the sample, did not differ according to the site of injury. Changes in appearance concern were, however, strongly associated with psychological distress at follow up.
We conclude that, although appearance concern is severe among some people with facial injury it is not especially different to the those with non-facial injuries or the general public; changes in appearance concern, however, appear to correlate with  psychological distress. We therefore suggest that interventions might focus on those with heightened appearance concern, and should target cognitive bias and psychological distress.

The objective of this study was to examine the psychometric properties of the Autobiographical Memory Test (AMT), which is widely used to measure overgeneral autobiographical memory in individuals with depression and a trauma history. Its factor structure and internal consistency have not been explored in a clinical sample. This study examined the psychometric properties of the AMT in a sample of recent trauma survivors (N = 194), who completed the AMT 2 weeks after a trauma. Participants were also assessed with structured clinical interviews for current acute stress disorder and current and past major depressive disorder. Confirmatory factor analysis and item response theory were used to analyze the AMT in the whole sample. The factor structure of the AMT was also compared for (a) individuals with and without lifetime major depressive disorder and (b) individuals with current (posttrauma) major depressive disorder and/or acute stress disorder versus those with neither disorder. In ...

To address the inconsistent findings and based on Hegel's dialectic contradictive principle, this study tested a parallel mediation model that may underlie the association of using prayer for coping with cardiac surgery outcomes. Three sequential interviews were conducted with 310 patients who underwent open-heart surgery. A structural equation model demonstrated that optimism mediated the favorable effect of prayer coping. Prayer coping was also related to preoperative stress symptoms, which had a counterbalance effect on outcomes. Age was associated with better preoperative mental health, but age-related chronic conditions were associated with poor outcomes; both of these were mediated through the same mediators.

Open any newspaper to find stories of technological disaster: oil spills threatening sea coasts and marine life, airplanes unleashing toxic cargos, trains and trucks spilling chemicals, dump sites seeping toxins into residential areas, nuclear plants spewing, leaking, and exploding radioactivity, high tech agriculture generating food panics, and terrorists releasing poisons into subways, and public places creating a new form of intimidation. Where technology was once viewed as the gateway to a bright future, we now realize that as discovery speeds ahead, so to does the potential for human and mechanical failure, and for malevolence. Technological disasters and toxic contamination have become the new bane of the 21rst century.
To cope with these new challenges one must ask, what exactly is a technological disaster and do these calamities differ from other stressors and from natural disasters? It is not always possible to separate natural disasters from technological disasters, as they may be a mixture of both. For instance, some of the consequences over natural disasters may be aggravated by human error such as is the case after earthquakes. There are however, distinct aspects to the experience of a toxic disaster. Havenaar (2001) defines a technological disaster as an exposure of human beings to a hazardous substance in a defined place over a defined span of time, due to some human error or action. The exposure may or may not be known at the time it occurs, but is learned of at some point, and harmful effects are attributed, whether accurately or not, to those who have been exposed to the toxins.
The major technological disasters of the last century include such calamities as the Bohpal industrial accident in India and the Chernobyl nuclear power plant explosion, which spewed radiation well beyond the borders of the former USSR. Well known American disasters include the Three Mile Island nuclear power leak, the Love Canal toxic waste leakage and the Valdez oil spill each with its unique stress profile for the populations affected. Probably, the worst wartime toxic contamination issue in history is the atomic bombing at Hiroshima, although concerns over wartime contamination continue: agent orange, gulf war syndrome and depleted uranium continue to loom large in the press. New on the scene are terrorist acts involving toxins: including the sarin poisoning in the Tokyo subway and the attempt of a terrorist to carry toxins into
the U.S., allegedly to commit plots in conjunction with millennium celebrations. Also new to the scene are victims who believe they have been exposed to microorganisms intended for germ warfare such as soldiers during the Gulf War and victims of the El Al air crash in the Netherlands who believe they were contaminated by cargo alleged to contain elements for germ warfare.
The publicity surrounding these larger disasters and contaminants sometimes overshadows the frequency of the more ordinary challenges: the spilled truckload of pool chemicals overturning in Australia, the train accident in Canada causing a three month evacuation of neighboring areas over Christmas, concerns in France over potential accidents during the movement of nuclear waste from Germany, Phillipino families living amidst toxic waste buried under an abandoned military base, and so on. While these events involve smaller geographical areas and less recognized threats they are increasingly frequent in most parts of the world and create the same sorts of fears and concerns over potential toxic contamination and the possible need for countermeasures including clean up and evacuation. Sadly, technological disaster involving toxic contamination, whether on the large or small scale are on the rise and will be a continuing challenge for years to come, hence the need for preparedness.
Caregivers, policy makers, public health officials, educators, emergency and health care workers and those who design and operate the technology of the future, all must educate themselves about this new, less well understood, threat to physical and psychological well being. And those in key positions of society must be prepared to prevent and remediate the psychological and health effects occurring in the aftermath of technological disasters. In that regard, this chapter examines the psychological and social mechanisms that are unique to toxic disasters and discusses means of averting and remediating the psychological distress and harmful mental health consequences that typically follow in the wake of technological disasters. It is also an attempt to provide an understanding of toxic contamination as a new and challenging traumatic stressor.

ABSTRACT This study investigates the reduced specificity of autobiographical memories in opioid-dependent patients and examines whether this phenomenon corresponds to an avoidance strategy in opioid-dependent patients and among the general population. Thirty opioid-dependent patients and 30 control participants were given Williams’ and Scott’s Autobiographical Memory Test (AMT) to evaluate the level of memory specificity. The use of cognitive avoidance strategy was measured with the Cognitive Avoidance Questionnaire (CAQ) and the level of depression with the Beck Depression 13 inventory (BDI 13). The AMT results confirm reduced memory specificity in the dependent patients, both for dependent patients with a depression diagnosis and for nondepressive dependent patients. Results also depict that the more participants (patients and control) use cognitive strategies of avoidance, the less they recall specific memories with the AMT. These data support the emotional avoidance hypothesis of reduced memory specificity in opioid-dependent patients and in the general population, regardless of a diagnosis of depression. Further research is needed to identify the emotion regulation function of reduced specificity in dependent patients. Furthermore, our findings do not exclude the implication of other mechanisms within autobiographical memory retrieval bias for dependent patients, such as a deficit of executive control. (PsycINFO Database Record (c) 2013 APA, all rights reserved)

We prospectively examined the relation between various peritraumatic responses (that is, fear, helplessness, horror, amnesia, and fright) and the development of posttraumatic stress disorder (PTSD) 2 months after a trauma. Participants included 123 motor vehicle accident (MVA) victims consecutively hospitalized in a traumatology department for over 72 hours during a 16-month period. Between day 2 and day 5 of their hospitalization, a psychiatrist assessed the patients' peritraumatic responses and acute stress disorder (ASD). Two months after the accident, an experienced psychiatrist contacted the patients by telephone, and the PTSD symptoms and the diagnosis were assessed with a modified version of the Clinician-Administered PTSD Scale (CAPS). Of the participants, 48 reported an immediate fright reaction when faced with the prospect of their own death. Participants who reported a fright experience had a 17 times greater risk of subsequently meeting the diagnostic criteria for PT...

This case study describes Cognitive Processing Therapy (CPT) with a 30-year-old guy man with symptoms of acute stress disorder (ASD) following a recent homophobic assault. Treatment addressed assault-related posttraumatic stress disorder symptoms and depressive symptoms. Also addressed were low self-esteem, helplessness, and high degrees of internalized homophobia. Client symptomatology was tracked using the PTSD Symptom Scale and the Beck Depression Inventory over the course of 12 sessions and for ...

This cross-national study examined preparation for and psychological functioning following Hurricane Georges in the U.S. Virgin Islands, Puerto Rico, Dominican Republic, and the United States. Four to five weeks after the storm made landfall, 697 college students (222 men, 476 women) completed a questionnaire assessing demographic characteristics, preparation, social support, resource loss, and symptoms associated with acute stress disorder. Location, resource loss (especially personal characteristic resources) and social support accounted for a significant portion of psychological distress variance. The findings support the conservation of resources stress theory (Hobfoll, 1989, 1998). Implications of the findings and future research directions are discussed.

The purpose of this study was to assess the prevalence and correlates of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in mothers and fathers, and postpartum depression (PPD) in mothers, of infants in the Neonatal Intensive Care Unit (NICU). 86 mothers and 41 fathers completed measures of ASD and of parent perception of infant medical severity 3-5 days after the infant's NICU admission (T1), and measures of PTSD and PPD 30 days later (T2). 35% of mothers and 24% of fathers met ASD diagnostic criteria at T1, and 15% of mothers and 8% of fathers met PTSD diagnostic criteria at T2. PTSD symptom severity was correlated with concurrent stressors and family history of anxiety and depression. Rates of ASD/PTSD in parents of hospitalized infants are consistent with rates in other acute illness and injury populations, suggesting relevance of traumatic stress in characterizing parent experience during and after the NICU.

9-11 woke the world up to the scourge of the 21rst century –suicidal terrorism. Hostage taking coupled with suicidal terrorism is its newest variant, played out in a Moscow theater in late October 2002. Forty Chechen terrorists armed with automatic rifles, grenades and self-detonating bombs announced to 800 plus hostages that the event was a suicide mission. The standoff ended when Russian Special Forces gassed and stormed the building killing all the terrorists. Suicidal terrorists are rarely, if ever observed in action. In the first months after the event an American psychologist collaborated with Russian Academy of Sciences colleagues to collect interviews from the hostages. This paper reports on hostages’ observations, interactions and conversations with the forty suicidal terrorists.

Despite clinical observations that many veterans have multiple sources of war-related guilt, many problematic guilt issues are commonly not treated or even detected by clinicians. We describe development of a survey that systematically assesses idiosyncratic sources of guilt across the spectrum of events mat are potential sources of trauma-related guilt from the war-zone. A multimethod strategy was used to develop a survey with strong content validity. Results indicate the survey is temporally stable, substantially correlated with other measures of guilt, and highly correlated with measures of posttraumatic stress disorder (PTSD) and depression. Findings confirm that many Vietnam veterans have multiple sources of severe war-related guilt. The survey may have important clinical utility for problem identification, treatment planning, and evaluating treatment efficacy.

Addressing the lack of self-report tools for acute stress disorder assessment, the authors aimed at translating and evaluating the Acute Stress Disorder Scale (ASDS) into German. The scale was applied to parents of children following cardiopulmonary bypass surgery (n = 61), and to patients with an acute cardiac event (n = 52) within one month of illness-related trauma. Indices of reliability, construct, and predictive validity with established measures of posttraumatic stress, anxiety, and depression suggest that the German ASDS is a psychometrically sound and valid instrument.

This study aimed to explore posttraumatic distress and the cognitive variables of controllability and predictability in two demographically matched communities differentially affected by the Christchurch earthquake of September 4, 2010 (N = 124). A door-to-door survey was conducted 8–10 weeks after the initial quake. The two communities did not differ on acute stress disorder or symptoms, but the affected community had higher depression and anxiety scores. Depression, feeling on edge, and anxiety scores predicted acute stress symptoms. Uncontrollability of response to aftershocks predicted acute stress, depression, and anxiety symptoms. Results are discussed with reference to the impact of ongoing aftershocks and how they are likely to maintain a sense that responses to them are uncontrollable, which in turn maintains psychological distress.