Editor's note
Stress reactions run from Acute Stress Reactions and Adjustment Disorders to Post-traumatic Stress Disorder (PTSD). The first two, in many instances, may be thought of as time limited in their impact and respond to many different types of psychosocial interventions. The primary purpose of intervening in these disorders is to facilitate more effecting coping with the stressor, reduce functional impairment, and return the individual to his previous level of active functioning in the community. PTSD has been shown to respond to both trauma-focused cognitive-behavioral psychotherapies and to pharmacological agents, particularly the SSRIs, though other pharmacologic interventions may impact some of the disturbed affect, anxiety, and lability, and to psychosocial interventions. As with many other disorders, there is a treatment resistant group that remain significantly impaired despite treatment, and long-term management of symptoms becomes the primary goal.
Introduction: differences in classification of stress disorders
The adjustment disorders, acute stress disorder, and post-traumatic stress disorder (DSM-IV) all share the common feature of occurring as a response to an adverse environmental event or cluster of events. The distinction appears clear cut; post-traumatic stress disorders follow extreme stressors that are operationally defined, whereas adjustment disorders may follow any kind of stressor of a less serious degree.
Adjustment disorders are defined as “clinically significant emotional or behavioral symptoms in response to an identifiable psychosocial stressor or stressors” (DSM-IV), and must develop within 3 months of the stressor (DSM-IV).