CHAPTER 13
Stress Disorders
This chapter is primarily concerned with diagnosable disorders that arise
after discrete major shocks such as being trapped in a burning building,
being raped, or seeing your mother held up at gunpoint. These are the
sorts of shocks that can potentially trigger a post-traumatic stress disorder.
This chapter is not about the damage caused by less intense but longer-
term stresses such as having a disabling illness, being bullied, or living
with parents who constantly fight or suffer from serious mental disorders.
These adversities and related coping processes are discussed in Chapter 34,
which should be read in conjunction with this chapter.
DSM-IV and ICD-10 include three disorders that can result from discrete
shocks:
1 Post-Traumatic Stress Disorder(PTSD) has a precisely defined symptom
profile that needs to have been present for at least a month. It is a
response to an event that would have distressed almost anyone. That
being so, some experts question whether labelling this understandable
distress as a disorder is an unwarranted medicalisation of the human
condition. This is a reasonable concern but there are possible counter-
arguments:
(a)While distress after a serious shock is understandable, some of the
symptoms of PTSD – such as flashbacks – are not part of normal
distress.
(b)When many individuals are exposed to the same catastrophe, some
develop relatively mild self-limiting symptoms while others develop
severe persistent symptoms. Thus a prolonged adverse reaction is far
from inevitable.
(c)Prolonged reactions can cause severe impairment in everyday
activities.
(d)Recovery can be hastened by the recognition of PTSD and the
administration of relatively specific treatments.
2 Acute stress disorder, like PTSD, is triggered by an event that would have
distressed almost anyone, but differs from PTSD in lasting under a
month and having a slightly wider symptom profile.
Child and Adolescent Psychiatry, Third Edition. Robert Goodman and Stephen Scott.
©c2012 Robert Goodman and Stephen Scott. Published 2012 by John Wiley & Sons, Ltd.
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