How to cope with acute stress disorder?

The first symptoms of acute stress disorder (ASD) can appear within a few days after experiencing a traumatic event and can significantly disrupt daily activities. Common symptoms of ASD include concentration problems, an inability to experience positive emotions, recurrent distressing dreams about the event, and irritability. Coping with acute stress disorder is crucial in the short term (as it reduces ASD symptoms [1],[2],[3],[4] and improves quality of life [5]) and in the long term (as it helps prevent the development of PTSD [1],[2]). Fortunately, coping with ASD can often be done at home without professional help, provided the symptoms are not too severe. If you are interested in assessing the severity of your symptoms, please take the ASD test.
 

 
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At Barends Psychology Practice acute stress disorder treatment is offered (also online). Go to contact us to schedule a first, free-of-charge session.

 

Coping with Acute Stress Disorder – Understanding Why People Experience ASD Symptoms

A traumatic event is characterized by exposure to a life-threatening situation, serious injury, or sexual violence. Such experiences are extremely distressing and can cause changes in the brain. A growing body of evidence suggests that trauma can significantly affect brain structure and function, particularly in individuals who develop PTSD or show signs of PTSD:

• Women who developed PTSD following childhood sexual abuse had, on average, a 16% smaller hippocampal volume compared to those who did not develop PTSD and a 19% smaller volume compared to women without a history of sexual abuse and PTSD. Additionally, women with PTSD showed a failure of left hippocampal activation during a verbal memory task [6],[7].
• Enhanced right amygdala responses (i.e., functional abnormalities in brain responses to emotional stimuli) to ‘masked’ fearful faces are associated with chronic PTSD (as early as one month post-trauma) [8]. In this study, participants were briefly shown an emotional face (16ms) followed by a neutral face (100ms). Because 16ms is too short for conscious recognition, researchers could measure pure emotional responses.
• Adults who were in closer proximity to the 9/11 attacks (compared to those further away) had lower gray matter volume in the amygdala, hippocampus, insula, anterior cingulate, and medial prefrontal cortex, even after controlling for age, gender, and total gray matter volume [9].
• Lower gray matter volume in the left dorsal anterior cingulate cortex (ACC) was found in individuals who developed PTSD following a traumatic event [10], whereas non-PTSD subjects had smaller gray matter volume in the right pulvinar and left pallidum, areas associated with severe stress responses.

These brain changes may explain certain ASD symptoms, such as concentration problems, nightmares, irritability, negative mood, and intense or prolonged psychological distress. Avoiding distressing feelings, thoughts, and memories associated with the trauma can be seen as a protective mechanism of the brain to prevent further damage. Unfortunately, avoidance coping is linked to greater PTSD and ASD symptoms [11],[12],[17] compared to active coping strategies, which include problem-solving, cognitive restructuring, emotional expression, and seeking social support [12].

In other words, experiencing ASD symptoms after trauma is more common than one might think and could be partly explained by brain changes. Fortunately, research shows that effective coping strategies can help reduce the severity of ASD symptoms.

 
 

Coping with Acute Stress Disorder – Reducing ASD Symptoms

There are several ways to lessen the impact of ASD symptoms. While some may feel counterintuitive or take time to show results, their effectiveness is supported by scientific literature. People who begin coping strategies soon after a traumatic event often feel a sense of control over their symptoms, reducing feelings of helplessness [13].

• Cognitive appraisal:

  The way a person perceives a stressor determines their psychobiological reaction. Viewing a stressor as a threat leads to greater negative emotions, stress, and hopelessness. Seeing it as a challenge, however, results in lower negative emotions, positive arousal, and a sense of control [13],[16]. For example, panic attacks are common after trauma. Instead of viewing them as dangerous, recognize that they are temporary and often caused by irrational thoughts. Cognitive appraisal is one of the most effective strategies for coping with ASD.

 

• Social support:

  People who talk about their traumatic experience with their social network report fewer ASD and PTSD symptoms than those who socially withdraw [14],[16]. Engaging in conversations about trauma helps process thoughts and emotions, reducing the risk of developing PTSD [15].

 

• Distraction:

  Keeping yourself occupied can lower the likelihood of developing ASD or PTSD [15]. Find positive ways to distract yourself, such as engaging in creative activities. Flashbacks are common after trauma, but distractions—such as walking, talking to someone, or solving puzzles—can help stop them. Choose activities that require active focus to prevent automatic re-engagement with the flashback.

 

• Religious coping:

  People who use religious or spiritual coping strategies tend to recover better from ASD and PTSD. Interestingly, those who rely on religious coping recover more effectively than those using only spiritual coping [16].

 

• Rhythm:

  Maintaining a regular sleep schedule reduces the risk of sleep disturbances, concentration problems, anger, and irritability. In general, having a structured routine helps the body and mind prepare for daily activities, reducing negative emotions. Strategies for managing anger and irritability include:
  • Distracting yourself (e.g., drinking a glass of water) when feeling upset.
  • Recognizing that heightened emotions are common after trauma.
  • Informing those around you about your recent experience so they can adjust their interactions accordingly.

 

• Talk to a therapist:

  If coping with ASD feels overwhelming, consider seeking professional help. At Barends Psychology Practice, the first session is free of charge and without obligation. We can discuss your trauma and symptoms and create a treatment plan tailored to your recovery.

 
 

Literature

• [1] Kornør, H., Winje, D., Ekeberg, Ø., Weisæth, L., Kirkehei, I., Johansen, K., & Steiro, A. (2008). Early trauma-focused cognitive-behavioural therapy to prevent chronic post-traumatic stress disorder and related symptoms: a systematic review and meta-analysis. BMC psychiatry, 8, 81.
• [2] Ponniah, K., & Hollon, S. D. (2009). Empirically supported psychological treatments for adult acute stress disorder and posttraumatic stress disorder: a review. Depression and anxiety, 26, 1086-1109.
• [3] Forbes, D., Creamer, M., Phelps, A., Bryant, R., McFarlane, A., Devilly, G. J., … & Newton, S. (2007). Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder. Australian & New Zealand Journal of Psychiatry, 41, 637-648.
• [4] Holbrook, T. L., Hoyt, D. B., Coimbra, R., Potenza, B., Sise, M., & Anderson, J. P. (2005). High rates of acute stress disorder impact quality-of-life outcomes in injured adolescents: mechanism and gender predict acute stress disorder risk. Journal of Trauma and Acute Care Surgery, 59, 1126-1130.
• [5] Van Emmerik, A. A., Kamphuis, J. H., & Emmelkamp, P. M. (2008). Treating acute stress disorder and posttraumatic stress disorder with cognitive behavioral therapy or structured writing therapy: A randomized controlled trial. Psychotherapy and psychosomatics, 77, 93-100.

 

Literature – part 2. Coping with acute stress disorder

• [6] Bremner, J. D., Vythilingam, M., Vermetten, E., Southwick, S. M., McGlashan, T., Nazeer, A., … & Ng, C. K. (2003). MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder. American Journal of Psychiatry, 160, 924-932.
• [7] Villarreal, G., Hamilton, D. A., Petropoulos, H., Driscoll, I., Rowland, L. M., Griego, J. A., … & Brooks, W. M. (2002). Reduced hippocampal volume and total white matter volume in posttraumatic stress disorder. Biological psychiatry, 52, 119-125.
• [8] Armony, J. L., Corbo, V., Clément, M. H., & Brunet, A. (2005). Amygdala response in patients with acute PTSD to masked and unmasked emotional facial expressions. American Journal of Psychiatry, 162, 1961-1963.
• [9] Ganzel, B. L., Kim, P., Glover, G. H., & Temple, E. (2008). Resilience after 9/11: multimodal neuroimaging evidence for stress-related change in the healthy adult brain. Neuroimage, 40, 788-795.
• [10] Chen, Y., Fu, K., Feng, C., Tang, L., Zhang, J., Huan, Y., … & Ma, C. (2012). Different regional gray matter loss in recent onset PTSD and non PTSD after a single prolonged trauma exposure. PLoS One, 7, e48298.
• [11] Lawrence, J. W., & Fauerbach, J. A. (2003). Personality, coping, chronic stress, social support and PTSD symptoms among adult burn survivors: a path analysis. The Journal of burn care & rehabilitation, 24, 63-72.
• [12] Iverson, K. M., Litwack, S. D., Pineles, S. L., Suvak, M. K., Vaughn, R. A., & Resick, P. A. (2013). Predictors of intimate partner violence revictimization: The relative impact of distinct PTSD symptoms, dissociation, and coping strategies. Journal of traumatic stress, 26, 102-110.
• [13] Olff, M., Langeland, W., & Gersons, B. P. (2005). The psychobiology of PTSD: coping with trauma. Psychoneuroendocrinology, 30, 974-982.
• [14] Pietrzak, R. H., Harpaz-Rotem, I., & Southwick, S. M. (2011). Cognitive-behavioral coping strategies associated with combat-related PTSD in treatment-seeking OEF–OIF veterans. Psychiatry Research, 189, 251-258.
• [15] Holeva, V., Tarrier, N., & Wells, A. (2001). Prevalence and predictors of acute stress disorder and PTSD following road traffic accidents: Thought control strategies and social support. Behavior Therapy, 32, 65-83.
• [16] Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of loss and trauma, 14, 364-388.
• [17] Pineles, S. L., Mostoufi, S. M., Ready, C. B., Street, A. E., Griffin, M. G., & Resick, P. A. (2011). Trauma reactivity, avoidant coping, and PTSD symptoms: A moderating relationship?. Journal of abnormal psychology, 120, 240.