Responses to crises and other trauma-causing events often are normal responses to
abnormal situations. When these responses result in difficulty functioning in daily life,
counselors need to consider if the client needs specialized conceptualization within a
diagnostic framework. Some diagnoses that require clinical conceptualization and
treatment include posttraumatic stress disorder (PTSD), complex posttraumatic stress
disorder (C-PTSD), acute stress disorder, and dissociation. Each of these diagnoses is
distinct in terms of how the individual experiences the traumatic event and the
idiosyncratic nature of the individual experiencing it. It is important to fully assess a
client’s situation before determining a diagnostic category so as to better ensure the most
appropriate treatment intervention.
With these thoughts in mind:
*Post two similarities and two differences between PTSD and Acute stress disorder.
*Explain how you might determine the accuracy of PTSD and acute stress disorder.
Diagnosis Specific to Crisis and Trauma
Similarities differences between PTSD and Acute stress disorder
Both PTSD and Acute Stress Disorder are disorders that a person suffers from as a result
of exposure to a traumatic event. The patient may have confronted, witnessed, or experienced an
event involving a serious injury, an actual threat of death, or a threat to his or her integrity. The
patient must have encountered intense horror, fear, or helplessness as a response to the traumatic
event or events (Foa & Hearst-Ikeda, 1996; Harvey & Bryant, 1998).
The second similarity between Acute Stress Disorder and PTSD is that their symptoms
are the same. The symptoms are divided into three categories: hyperarousal symptoms,
avoidance symptoms, and re-esperiencing symptoms. Hyperarousal symptoms include
jumpiness, concentration difficulties, outbursts of anger, irritability, and sleep problems.
Avoidance symptoms include memory lapses, feeling distant, lack of interest, and avoidance of
people, places, feelings, coversations, and thoughts that remind the person of the event. Re-
experiencing symptoms include strong reactions toward reminders of the event, flashbacks,
nightmares, memories or thoughts (Harvey & Bryant, 1998).
DIAGNOSIS SPECIFIC TO CRISIS AND TRAUMA 2
The most significant difference between Acute Stress Disorder and PTSD is the duration
of the symptoms. The overall symptoms for Acute Stress Disorder last for about two to four days
within the month in which the traumatic event occurs. On the other hand, the symptoms for
PTSD last for about four weeks. The second difference between Acute Stress Disorder and
PTSD is that PTSD is divided into three: delayed onset for symptoms that occur six months after
the traumatic event, chronic for symptoms that occur three months after the event, and acute for
symptoms that occur three months within the event. In addition, PTSD has a wider range of
symptoms than Acute Stress Disorder.
Determining the accuracy of PTSD and acute stress disorder
To accurately determine the accuracy of PTSD and Acute Stress Disorder, it is important
to establish whether a person meets certain requirements. For Acute Stress Disorders, the DSM
describes the requirements as follows:
Criterion A: The patient must have confronted, witnessed, or experienced an event that
occasioned him or her a serious injury or death threat and the patient reacted with a strong sense
of horror, helplessness, or fear.
Criterion B: The patient must have encountered at least three of the following symptoms:
depersonalization, derealization, not being aware of the environment, and having detached
Criterion C: The patient must have at least one re-experiencing symptom such as dreams,
memories, or thoughts about the event.
Criterion D: The patient must have attempted to avoid the things, places, or people capable of
reminding him or her about the traumatic event.
DIAGNOSIS SPECIFIC TO CRISIS AND TRAUMA 3
Criterion E: The patient must have hyperarousal symptoms such as irritability and concentation
Criterion F: The symptoms must be having a strong negative effect on the life of the patient.
Criterion G: The patient must have experienced the symptoms for at least two days up to 28
days. The symptoms should also take place within twenty-eight days of the traumatic event.
Criterion H: The symptoms must not have arisen from an illness or another medical condition,
alcohol or medication.
A person suffering from an Acte Stress Disorder has high chances of ultimately developing
PTSD. The symptoms of Acute Stress Disorder may lead to acute, chronic, or delayed PTSD
depending of the time of their occurrence. It is unfortunate that there is no known cure for PTSD.
The determination of PTSD is solely based on the symptoms of Acute Stress Disorder (Bryant et
DIAGNOSIS SPECIFIC TO CRISIS AND TRAUMA 4
Bryant, R. A., Harvey, A. G., Guthrie, R. M., & Moulds, M. L. (2000). A prospective study of
psychophysiological arousal, acute stress disorder, and posttraumatic stress disorder. Journal of
Abnormal Psychology, 109(2), 341.
Foa, E.B., & Hearst-Ikeda, D. (1996). Emotional dissociation in response to trauma: An
information-processing approach. In L.K. Michelson & W.J. Ray (Eds.), Handbook of
dissociation: Theoretical and clinical perspectives (pp. 207-222). New York, NY: Plenum Press.
Harvey, A.G., & Bryant, R.A. (1998). The relationship between acute stress disorder and
posttraumatic stress disorder: A prospective evaluation of motor vehicle accident survivors.
Journal of Consulting and Clinical Psychology, 66, 507-512.