Welcome. In this video we will talk on the acute stress disorder and the posttraumatic stress disorder. Acute stress disorder is the normal reaction to an exceptional stress situation when our confrontation capacities get overwhelmed by the magnitude of the thing we just lived. It is transitory, it usually appears during the first 6 weeks from the moment we have lived this traumatic incident and it's relatively serious. In the two most recognized manuals of disorder diagnostic classification, the CIE-10 and the DSM-5, now in its current version, categorize it, the DSM pathologies it, instead the CIE normalizes it. It is a normal reaction in front of this kind of incidents which as we have already said is transitory, so it diminishes during the hours or the days that follow the incident. The basic differences are that while the DSM includes only physical symptoms and it extends its duration (in fact it defines it as the precursor of the posttraumatic stress), the CIE emphasizes this transitory position, this short duration and emphasizes the normalizing role of this kind of reactions. Which would be the key concepts in the posttraumatic stress disease then? Well, the posttraumatic stress disorder is a more serious disorder, it is a planned disorder that stretches on time. It is also due to a traumatic incident, as an answer to an incident that has a major stress than the normal, but this disease doesn't weaken, it can't be healed without professional assistance. There are some places that can find out that the posttraumatic stress disorder is an acute stress disorder that hasn't been properly managed, according to the definition given by the DSM. They key here would be the duration of the symptoms, we should worry if they lasted more than a month. Which diagnostic criteria are given for the posttraumatic stress disorder? The fact that there has been a real exposition to a traumatic incident. A traumatic incident is that our physical integrity, our life or a loved one's life is in danger, or that the physical integrity of a loved person or that we see how someone's life or physical integrity is in danger and finally we see a murder, or if we see a criminal act on another person, a rape or a death. In example, seeing how a mate dies in the mountain would be a traumatic incident. Which are the posttraumatic stress disorder characteristics? It is defined because we reexperience the incident in an intrusive way and as we have the reexperience we try to avoid anything that can make us remember or think of the incident. We are more nervous, we have an hyper-activation due to the traumatic incident. We said that it lasts more than one month, so we must ask for help and the most important to consider it a disease, which can suit any disease categorized in the DSM, is that it must have an effect on the daily life. What does it mean an effect on the daily life? That it complicates a satisfying life in our different development fields, either professional, familiar, social, that it complicates our home relations, being with our friends, the normal execution of our jobs, the work performance, this would be the daily life's affectation. Let's see the symptoms with more details. We'll begin with the acute stress disorder. There are five axis. We said that there's a hyper alert, right? How does this hyper alert appear? Mostly in problems with sleeping, either insomnia, not being able to sleep, waking up repeatedly during the night, waking up in the night and not being able to sleep again, we will be more irritable, more nervous, we will easily get angry, right? Anything will make us react more exaggeratedly than we would usually do. The next axis is the reexperience, having flashbacks, experiencing again all what happened in the traumatic incident, and it's an intrusive reexperience, we don't think about it, thoughts unwillingly come into our head and we have nightmares, we keep dreaming on the traumatic incident, which makes us trying to avoid as much as we can the places or the people that remind us of the traumatic incident, we get into some kind of emotional anesthesia, we are dull and we have the feeling that we won't be able to carry on with our life. The fourth axis is the dissociative symptoms. What does dissociative symptoms mean? We have a surrealism feeling, as if we weren't ourselves, we are like in stand-by, we see our life from the outside, it is a feeling of being there without being there, that things aren't happening, that it can't be true, that it's a dream. We might even forget or not remember, we could be unable to remember concrete moments in the traumatic incident that we have deleted, we have a gap in our mind. And the last axis is the damage on the functional capacity. We feel sick, we suffer, we find harder doing anything we usually did before, we stop doing many things we did before the incident and this stops our normal life, understanding "normal" as the life we had before the traumatic incident. Instead in the posttraumatic stress disease symptomatology we will look mostly at three axis. One marks the hyper activation level we have, as we are in a hyper alert state. We have difficulties at sleeping but also at focusing, we aren't able to keep doing the same activity for a long time, and less an activity that consumes us at a mental level, and we are more irritable than usual, we can even have rage attacks in front of things or feelings that didn't provoke us these annoyance before. We also have reexperiencing, the same definition we have given before can be used for the posttraumatic stress disorder. The flashbacks, the intrusive images thoughts, the memories that come to our minds, we revive the traumatic incident, they can even be flashbacks in any of the senses, even the sense of smell in the people that has been involved in a serious fire, it lasts, this burning smell, they are making a normal activity in their daily life, some weeks after the incident has passed, and the burning smell comes back. So in the posttraumatic stress disorder they would keep having these feelings. As in the acute stress disorder, all this discomfort, all this activation, all this reexperience makes us avoid everything that reminds us of this traumatic incident, either people, news or places that can make us remember, although it is true that mostly at the beginning there are moments where we tend to look for information on the incident, a sometimes massive and damaging exposition to the news of what happened, and anything that remembers us to the incident reopens the wound and somehow we try to avoid it. Acute stress disorder is very common, as most of the population have suffered a traumatic incident in their lives, which can be the death of a relative, during our lives our beloved ones die and these are traumatic experiences, being diagnosed with a serious illness or it being diagnosed to a close relative. They don't need to be huge traumatic incidents, we all have traumatic incidents in our daily life. So most of the people has lived them. However, the acute stress dominance obviously diminishes with time, as it is a transitory disorder that diminishes. What does this mean? This means that the epidemiology taxes and studies change, especially depending on the culture or the environment where they are made. The most reliable data are those related to the fact that, despite it can happen in any age, there is a difference between genders. There is more posttraumatic stress disorder detected in those women who have suffered or still suffer sexual or physical abuse. Instead in men there are more diagnoses in those who battle or that have had a physical aggression. Where do we generally find acute stress disorders? In extreme trauma situations, in huge natural disasters, such as the tsunami that happened some years ago, in hurricanes that have happened in the USA, in this kind of situations, the first reactions, the ones we can generally see are acute stress disorder reactions. Instead, in the posttraumatic stress disorder there is a big difference depending on where we are seeing this epidemiology, if it's a territory with an open conflict or not, and it's true that luckily most of the people doesn't develop a posttraumatic stress disorder, a 65% of the adults recover without effect from the traumatic incident. It doesn't mean they haven't had an acute stress disorder, maybe they have had an acute stress reaction that has gradually diminished, they have had good psychological first aid, they have been given good guidelines and the person has been able to escape from this traumatic incident without any complications. However there is a 35% that develops posttraumatic stress disorder. We could discuss whether the acute stress disorder has been properly managed or not. However, wherever this posttraumatic stress disorder comes from, either if they were risk factors, if it's because the initial moment hadn't been properly managed, because there hasn't been a good monitoring, there hasn't been a good prevention, it is true that in this disease usually there are more woman than men affected by it. Almost a 10% of women is affected while only 4% of men are.
