Traumatic Stress
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Traumatic stress is a common term for reactive
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
and depression, although it is not a medical term and is not included in the ''
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...
'' (DSM). The experience of traumatic stress include subtypes of
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
, depression and disturbance of conduct along with combinations of these symptoms. This may result from events that are less threatening and distressing than those that lead to
post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental disorder that develops from experiencing a Psychological trauma, traumatic event, such as sexual assault, domestic violence, child abuse, warfare and its associated traumas, natural disaster ...
. The fifth edition of the DSM describes in a section titled "Trauma and Stress-Related Disorders" disinhibited social engagement disorder, reactive attachment disorder,
acute stress disorder Acute stress reaction (ASR), also known as psychological shock, mental shock, or simply shock, as well as acute stress disorder (ASD), is a psychological response to a terrifying, traumatic, or surprising experience. The reactions may include ...
,
adjustment disorder Adjustment disorder is a Mental disorder, mental and Abnormality (behavior), behavioral Mental disorder, disorder defined by a maladaptive response to a psychosocial stressor. The maladaptive response usually involves otherwise normal emotional a ...
, and
post-traumatic stress disorder Post-traumatic stress disorder (PTSD) is a mental disorder that develops from experiencing a Psychological trauma, traumatic event, such as sexual assault, domestic violence, child abuse, warfare and its associated traumas, natural disaster ...
.


Symptoms

Symptoms of traumatic stress can be both physical and emotional. Physical symptoms include trembling, shaking, a pounding heart, rapid breathing, choking feelings, stomach tightening/churning, dizziness/faintness, and cold sweats. Emotional symptoms include racing thoughts and excessive feelings of shock, disbelief,
fear Fear is an unpleasant emotion that arises in response to perception, perceived dangers or threats. Fear causes physiological and psychological changes. It may produce behavioral reactions such as mounting an aggressive response or fleeing the ...
,
sadness Sadness is an emotional pain associated with, or characterized by, feelings of disadvantage, loss, despair, grief, helplessness, disappointment and sorrow. An individual experiencing sadness may become quiet or lethargic, and withdraw the ...
, helplessness, guilt,
anger Anger, also known as wrath ( ; ) or rage (emotion), rage, is an intense emotional state involving a strong, uncomfortable and non-cooperative response to a perceived provocation, hurt, or threat. A person experiencing anger will often experie ...
, shame and
anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...
. Furthermore, many people revert to certain coping mechanisms. In children, that may include a loss of being able to take care of themselves (no longer able to eat on their own or be toilet trained). In adults, there can be an increase in impulsive behavior and dependence on others (leading to an inability for them to make "thoughtful, autonomous decisions".


Types


Dis-inhibited social engagement disorder

Dis-inhibited social engagement disorder is a stress-related disorder stemming from neglect during childhood. According to Erikson's work on the stages of psychosocial development, the psycho-social crisis of trust versus mistrust during infancy causes neglect during that period to have permanent effects because a neglected infant does not learn to trust his parent(s). Feelings of mistrust and anxiety may eventually lead to traumatic stress, especially through dis-inhibited social engagement disorder, among others. Symptom persistence is necessary for a diagnosis of dis-inhibited social engagement disorder: specific symptoms must be present for at least twelve months.


Reactive attachment disorder

Reactive attachment disorder is a trauma disorder that arises when a parent does not console an upset child. A repetition of this behavior causes sadness, irritability, and fear, which can then lead to the disorder. A cluster of symptoms relating to indiscriminate behaviors is regarded as dis-inhibited social engagement disorder rather than reactive attachment disorder; symptoms of reactive attachment disorder must be inhibited. Both dis-inhibited social engagement disorder and reactive attachment disorder are related to severe pathogenic care.


Acute stress disorder

Another disorder in this category is acute stress disorder, which is listed in DSM-5 under code 308.3, ICD-10, F43.0. According to the DSM-5 "Acute Stress Disorder is caused by trauma (traumatic stress) and lasts at least 3 days."


Adjustment disorder

Another disorder in this category is adjustment disorder DSM-5 code 309, ICD-10, F43-2. "Adjustment disorder is a manipulative reaction to identifiable psycho-
social stress Social stress is stress that stems from one's relationships with others and from the social environment in general. Based on the appraisal theory of emotion, stress arises when a person evaluates a situation as personally relevant and perceives ...
or(s) or life change(s) characterized by preoccupation with the stressor and failure to adapt."


Post-traumatic stress disorder

The last disorder listed in the DSM-5 is post-traumatic stress disorder. "Post-traumatic stress disorder (PTSD) is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault." Post-traumatic stress disorder is expressed through behavioral manifestations that resemble symptoms of PTSD. The diagnostic standards for PTSD encompass reliving the traumatic experience, avoiding triggers, and persistent hyperarousal. Post-traumatic stress disorder can affect people of all ages, including children as young as 2.


References


Further reading

* * {{refend Psychological stress Trauma types Adverse childhood experiences