Acute stress reaction

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Classification according to ICD-10
F43.0 Acute stress reaction
ICD-10 online (WHO version 2019)

The acute stress reaction (abbreviation ABR , more precisely: reaction to acute stress ; English acute stress disorder , ASD ) is a reaction of the human psyche to an extraordinary stress event. The psyche temporarily lacks a coping strategy , as a result of which all processing mechanisms collapse.

The acute stress reaction is coded in the WHO disease classification ICD-10 , but is classified as a normal reaction. In the DSM it is coded under 308.3 as an acute stress disorder.

Similar terms

  • mental decompensation
  • Colloquially nervous breakdown (English nervous breakdown ) as imprecise collective term for extreme psychological reactions.
  • Acute crisis response
  • Psychological shock

trigger

Frequent triggers are traumatic experiences such as accidents , natural disasters , experiences of violence or death , but also persistent stress . The stress usually represents a serious threat to the safety and physical integrity of the person concerned or a sudden and threatening change in the social situation of the person concerned. Depending on the individual psychological constitution of the person concerned, however, supposedly less drastic experiences can lead to an acute stress reaction ( see: Diathesis-Stress-Model ).

diagnosis

In the ICD-10, the acute stress reaction is described as a mixed picture, beginning with a type of "numb", with narrowed consciousness and reduced attention, an inability to process stimuli and disorientation. Often followed by withdrawal from the environmental situation (up to dissociative stupor ) or a state of restlessness and overactivity (such as escape reaction or dissociative fugue ). Vegetative signs of panic anxiety, such as tachycardia , sweating, and flushing, are most common. Partial or total amnesia related to this episode may occur.

In the acute phase - the so-called peritraumatic period (peritraumatic phase)- Above all, the person concerned is noticeably anesthetized. She seems to fail to notice important aspects of the situation or to take actions that seem inappropriate or completely pointless ( decreased consciousness , impaired perception and disorientation ). Dissociative symptoms also occur, i.e. the feeling of not being yourself or of experiencing everything as though through a filter or a camera ( depersonalization , derealization ). Mostly the most impressive for outsiders are the strong emotional fluctuations of people who experience an acute stress reaction. Pronounced sadness can quickly alternate with anger or aggression or apparent indifference . The signs mentioned above can be accompanied by a vegetative reaction, i.e. general stress reactions such as sweating , racing heart , tremors or nausea .

In the processing phase, the events can be relived ( intrusion ). This can also happen in the form of nightmares or as imposing memories ( flashbacks ). One possible consequence of this reliving is avoidance behavior , for example after a traffic accident the person concerned does not initially drive the same route as before.

In the differential diagnosis , the post-traumatic stress disorder and the adjustment disorder must be distinguished from the acute stress reaction.

course

The onset of an acute stress reaction usually begins with the experience of the stressful situation. The reaction lasts for hours to days, in rare cases weeks. The symptoms in the acute phase differ from those in the subsequent processing phase. Over time, the symptoms change, usually decrease, and usually go away completely.

If the symptoms persist for more than four weeks and this means that there is a psychological or social impairment, one speaks of an adjustment disorder or a post-traumatic stress disorder (PTSD), which is a disease that requires therapy.

See also

literature

Individual evidence

  1. ^ Frank H. Mader: General medicine and practice: Instructions in diagnostics, therapy and care. Specialist examination in general medicine, Springer-Verlag, 2013, p. 313 [1]
  2. a b WHO: Neurotic, stress and somatoform disorders (F40-F48). In: DIMDI. 2019, accessed August 3, 2019 .
  3. ^ Pschyrembel. Clinical Dictionary . 267th, revised edition. De Gruyter, Berlin / Boston 2017, ISBN 978-3-11-049497-6 .