User:Aelliott1252

Incident stress (rough draft)

(content below will be added to an existing page titled, "incident stress," before final project is due)

Symptomatology
Symptomatololgy associated with excessive acute or sustained stress may include cognitive impairments such as diminished memory, decision-making capacity, and attention span; emotional reactions such as anger, irritability, guilt, fear, paranoia, and depression; and physical problems ranging from fatigue, dizziness, migraine headaches, and high blood pressure to diabetes and cancer. Self-destructive and antisocial behavior may also be triggered.

Symptoms can vary depending on social factors, such as trauma severity, amount of social support, and additional life stresses.

Causes of incident stress
A critical incident that occurs to an individual is the starting point for incident stress if the individual is unable to cope. Critical incidents are defined as sudden, unexpected events that have an emotional impact sufficient to overwhelm the usually effective coping skills of an individual and cause significant psychological damage.

Healthy attachment amoung adults is key to managing critical incident stress. Adults have four attachment styles: 1) fearful avoidant, 2) anxious-preoccupied, 3) dismissive avoidant, and 4) secure. Fearful avoidant adults have mixed feelings about close relationships, because they want emotional connections but are very reluctant to allow them. Anxious-preoccupied adults tend to deal with their stress by distancing themselves from the reality of the situation to avoid the emotional burden. They also tend to see themselves negatively and doubt their worth in relationships frequently. Dismissive avoidant adults view themselves as self-sufficient, and in no need of emotional connectedness. Secure adults have positive views about themselves, and feel comfortable with independence and intimacy. Secure adults typically cope better with critical incident stress, as opposed to non-secure adults, because they develop less stress by nature. Secure adults are also less likely to develop posttraumatic stress disorder (PTSD).

The DSM IV-TR describes Posttraumatic Stress Disorder (PTSD) as having three distinct symptom clusters: 1) re-experiencing the event, 2) avoidance of stimuli associated with the event and numbing of general responsiveness, and 3) increased arousal. The first symptom cluster, re-experiencing the event, is a mixture of physical and pyschological reactions someone goes through after the critical event has occured. Those includes nightmares, reoccuring thoughts/flashbacks, or panic attacks. The second symptom cluster, avoidance of stimuli associated with the event and numbing of general responsiveness, occurs when someone avoids anything that could possibly trigger memories of the critical event. This includes thoughts and feelings associated with the event, and even physical stimuli such as people and places having to do with the event. The third symptom cluster, increased arousal, produces anxiety-driven responses, such as trouble sleeping, excessive anger and irritability, hypervigilance, poor concentration, and exaggerated startle response. When these symptoms persist for more than 2 weeks, a diagnosis of Acute Stress Disorder may be appropriate.

Factors, such as family psychiatric history, or childhood abuse may mediate the relationship between critical incidents and PTSD.

Incident stress management
Critical incident-stress debriefings (CISDs) have proven to be a successful coping method over the past 15 years for individuals in high-stress, emergency response professions. Nearly 300 CISD teams exist in the United States, offering intervention to fire, paramedic, police, and other emergency personnel. These debriefings are designed to offer emotional reassurance, time for ventilation of feelings, education about stress management, and consultation.

This technique was first implemented by Jeff Mitchell,PhD, of the International Critical Incident Stress Foundation, in 1983 to treat emergency care workers in the mental health profession. These debriefings were created to prevent worsening the stress and also promote recovery. Judith Herman, author of Trauma & Recovery, identified three critical conditions that must be satsfied in order to progress toward recovery: 1) safety, 2) rememberance and mourning, and 3) reconnection. Safety is achieved when victims learn to feel relaxed and trust in the recovery process by recognizing there are disturbed emotions. Rememberance and mourning of the critical incident is necessary...

Problem solving appraisals were tested as another possible method for coping with critical incident stress. The first successful testing of this technique was done by Dr. Sarah Baker and Dr. Karen Williams in the United Kingdom,using a testting group of stressed firefighters. These firefighters filled out anonymous self-report questionnaires that gaged their level of stress. This assessment had a dual purpose of acting as a way of acknowledging the stress, and also setting a standard for management effort accordingly.