Acute Stress Disorder
What is it?
Acute stress disorder is an anxiety disorder developed by a child within one month of being involved in, or witnessing, a severe traumatic event or learning about such an event involving a close family member. Such events include threatened death, the death of a love one or serious injury to themselves or a loved one. A child may be agitated or appear disorganized or dazed. If symptoms do not subside after one month it may lead to development of the more impairing Post Traumatic Stress Disorder (PTSD).
Signs and Symptoms
A child with acute stress disorder may be dazed at times or have a detached demeanor, nightmares, trouble sleeping, no memory of the event, or repeatedly act out the event during play time. The child may also be very anxious and avoid aspects of the event including location, the people involved, conversations, thoughts or feelings. Often a child with acute stress disorder fears the event recurring; any odd behavior displayed is their way of ensuring it won’t happen again.
Diagnosis and Treatment
To be diagnosed with acute stress disorder, a child will show three or more of the following symptoms: 1) detachment or absence of emotional responsiveness; 2) lack of awareness in his surroundings; 3) de-realization; 4) depersonalization; 5) dissociative amnesia (i.e., inability to recall an important aspect of the trauma). These symptoms typically present themselves up to 30 days after the traumatic event (source: The Diagnostic and Statistical Manual of Mental Disorders, 4th ed.; DSM–IV; American Psychiatric Association, 1994).
Many cases of acute stress disorder resolve themselves over time but in some cases cognitive therapy is effective.
What are the risk factors for children?
Children with prior mental disorder are more susceptible to developing acute stress disorder as are those exposed to prior traumatic events. Children who feel a deep sense of powerlessness or guilt over the event, or feel personally responsible for it, may develop the disorder. Girls are at higher risk.