In the world we live in, individuals may encounter various forms of trauma or extreme stress events, from natural disasters to human-induced violence, from sudden loss to wars and conflicts (Smith, 2019). The impact of these events, especially on the psychological and emotional levels, may last for a long time, even a lifetime (Jones & Williams, 2020). Among many mental health disorders, Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) are two reactions directly related to such traumatic events. To some extent, both represent people's psychological and emotional reactions after experiencing extreme stress. This report will provide an in-depth analysis of the concepts, diagnostic criteria, real-life cases, and the latest treatment methods for these two disorders.

What is PTSD?

Post-Traumatic Stress Disorder (PTSD) is a series of persistent psychological reactions that arise from experiencing some form of traumatic event, such as war, severe physical harm, sexual assault, terrorist attacks, etc. The DSM-5, or "Diagnostic and Statistical Manual of Mental Disorders Fifth Edition," provides us with clear diagnostic criteria for PTSD (American Psychiatric Association, 2013). Firstly, there must be direct or indirect trauma exposure. This could be personally experienced, witnessed, or being frequently exposed to related information at work, such as forensic personnel or first responders. Secondly, patients might continuously and repeatedly experience flashbacks, nightmares, or intrusive thoughts related to the trauma. Moreover, they may actively avoid anything related to the trauma, including avoiding places, people, or activities related to it, and might display emotional numbness towards the external world. In terms of negative emotions and thoughts, patients might often feel guilt, blame themselves, or feel alienated from others. Lastly, pronounced hyper-reactivity may manifest as overreacting to sudden noises or movements, /2 9 anger, sleep problems, or excessive alertness (DSM-5 2016). For detailed diagnostic criteria, please refer to the DSM-5. Regarding PTSD, consider the following two typical cases: 1) John, a veteran of the Iraq war, often experiences flashbacks of combat, especially when hearing explosions or gunshots. He frequently wakes up from terrifying nightmares at night, finding himself drenched in sweat. In daily life, he avoids socializing, especially with those who might discuss the war. 2) Mary, a survivor of sexual assault, still can't enter a dark room or be alone with unfamiliar males, even five years after the incident. Whenever she tries to develop intimate relationships, she recalls that horrifying night.

What is ASD?

Acute Stress Disorder (ASD) is very similar to PTSD, but its symptoms appear over a shorter duration, typically within 3 days to 4 weeks after the traumatic event (DSM-5 2016). For detailed diagnostic criteria, please refer to the DSM-5. For ASD, consider the following examples: 1) Alice, a survivor of an earthquake, began experiencing intense dissociation the day after the event, often feeling like she was in a dream. She also frequently avoids close contact with family and friends, fearing another loss. 2) Although unharmed, Bob, a witness to a bank hijacking, avoids entering any bank for two weeks following the incident and often dreams of the hijacking scenario. /3 9

Psychotherapy

The goal of treating PTSD is to help victims regain control over their lives. While psychotherapy is the preferred treatment, medication is also an effective option. Several psychotherapies or talk therapies are available for PTSD in children and adults. Common methods include:

1. Cognitive Therapy: This method aims to help patients identify and change thought patterns causing issues, like negative views about

themselves or excessive worries about recurring trauma. For PTSD, it's usually combined with exposure therapy.

2. Exposure Therapy: This therapy helps face and deal with terrifying memories or situations in a safe environment, thus learning how to cope effectively. It's particularly effective for situational recollections and nightmares of PTSD. At times, virtual reality technology might be employed to help confront and process traumatic experiences.

3. Eye Movement Desensitization and Reprocessing (EMDR): EMDR combines exposure therapy with a series of guided eye movements, aiming to process traumatic memories and change one's response to them. The most recommended intervention is Cognitive Behavioral Therapy

(CBT) (APA 2020), suggested 1-2 times weekly for 4-16 weeks (APA 2020).

Moreover, therapists also teach how to cultivate stress-coping skills, enabling patients to cope better with stressors in daily life. Combining various treatments can help overcome long-term fears post-trauma. Patients can discuss the treatment best suited to their needs with mental health professionals. Whether opting for individual therapy, group therapy, or a combination of both, group therapy offers patients a chance to interact with those having similar experiences.

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The primary goal for treating ASD is to alleviate symptoms and prevent its progression to PTSD, usually utilizing Cognitive Behavioral Therapy. Sub-clinical Psychological Responses that do not Constitute PTSD and ASD Diagnoses It's important to understand that the effects of psychological trauma can be multifaceted. Even if individuals do not develop into diagnosable disorders such as Post-Traumatic Stress Disorder (PTSD) or Acute Stress Disorder (ASD), they might still experience long-term impacts that can affect various facets of their lives. The consequences can range from minor disruptions to significant

impairments in daily functioning.

1. Emotional reactions: This might include persistent feelings of sadness, anger, guilt, or emotional numbness. Individuals might find themselves more irritable or often feeling overwhelmed or hopeless.

2. Cognitive changes: Some might struggle with concentration or decision-making. They may also develop negative beliefs about themselves, others, or the world at large, such as thinking, "I'm incompetent” or "Theworld is a dangerous place.”

3. Behavioral changes: This can manifest as avoidance behaviors, where individuals might steer clear of places, people, or activities that remind them of the traumatic event. They might also develop new habits or routines to minimize perceived risks.

4. Physiological symptoms: The traumatic event can lead to sleep disturbances like insomnia or nightmares. Some might also experience fatigue, get easily startled, or constantly feel on edge.

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5. Interpersonal difficulties: Trauma might impair one's ability to trust others, posing challenges in forming new relationships or maintaining existing ones. It can also impact intimate relationships and family dynamics.

6. Substance use: Some individuals might turn to alcohol, drugs, or other substances to cope with emotional distress, potentially leading to addiction or dependence. While these impacts might not necessarily meet the criteria for PTSD or ASD, they remain significant and warrant attention. Recognizing these symptoms and seeking appropriate support, whether through therapy, counseling, or other resources, is key to healing and recovery.

Post-Traumatic Growth

Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) are often perceived as psychological disorders bringing negative consequences. However, this doesn't mean traumatic experiences lead solely to adverse outcomes. In some situations, after undergoing trauma, an individual might experience what is termed as "Post-Traumatic Growth" (PTG).

What is Post-Traumatic Growth (PTG)?

PTG is a psychological concept that depicts the positive psychological changes people might undergo following significant trauma or stressful events. Such transformations often manifest as an increase in psychological resilience, life's purpose, interpersonal relationships, and personal strength. Unlike merely "recovering" to the state prior to trauma, PTG entails a more profound shift, enabling the individual to better tackle current challenges and potentially other challenges they might face in the future. According to a systematic analysis by /6 9 Wu et al., nearly 50% of trauma survivors experience moderate to high post- traumatic growth after traumatic events (Wu, 2019).

Case Study:

A lady who lost her home in an earthquake, after the initial shock, grief, and fear, chose to partake in the reconstruction of her community. In this process, she discovered her leadership abilities. The calamity made her re-evaluate her life's objectives, deciding to devote more to charitable causes. While she'll never forget the pain the earthquake brought, she did derive a new life direction and purpose from it.

How to Achieve PTG? Indeed, PTG offers a more comprehensive and positive perspective on how growth and development opportunities can be identified from distressing experiences. Achieving this, however, is not simple, and not everyone will undergo this positive transformation. For those aspiring to grow personally through trauma, the following suggestions might provide some insight:

1. Enhance psychological resilience: This ability to cope with stress and adversities can be nurtured in various ways, including learning mental adjustment techniques, physical exercise, and seeking social support.

2. Establish a robust support network: Studies indicate that a strong social support network can foster PTG. Support from friends and family is vital, but professional psychological therapy and counseling can sometimes offer invaluable help.

3. Accept and confront reality: Post-trauma, acknowledging and facing the painful experience is the initial step. Denial or evasion generally prolongs the agony. /7 9

4. Positive mindset and expectations: Expectations significantly impact an individual's recovery process. Recognizing the potential for growth from the trauma can act as a positive psychological catalyst.

5. Engage in deep self-reflection: Reflecting on the past, present, and

future helps find new meanings and objectives. This reshaping of meaning might be pivotal for PTG.

6. Take action: Sometimes, the best therapy is to act. This might involve seeking professional aid, sharing your story with others, or finding a meaningful way to commemorate or alleviate the experienced trauma.

7. Lifelong learning and adaptation: PTG is an ongoing process demanding continuous learning and adaptation. This might entail regularly adjusting your mindset, behaviors, and social strategies to fit the ever- changing personal and societal environments.

Understanding PTG doesn't mean belittling or overlooking the pain and intricacies that trauma brings. On the contrary, it offers a fresh perspective and tools, enabling us to surpass the "victim" label and confront trauma more comprehensively, positively, and powerfully. This process is intricate but invaluable, worthy of anyone willing to face and transcend themselves. Viewing oneself merely as a "victim" might trap us in an inescapable loop. Yet, the concept of PTG encourages us to surpass this label, recognizing our innate strength and potential. It not only maps out the path from trauma to recovery but shows us the route to transform pain into power, rediscovering life's meaning and objectives. Hence, every adversity can be seen as an opportunity for learning and growth, provided we're willing to seek and create meaning from it. /8 9

Conclusion

In summary, PTSD and ASD are two intricate psychological disorders triggered by stressful events. While numerous treatment methods exist, the key lies in timely identification and intervention to prevent long-term adverse impacts. Furthermore, social and family support plays a pivotal role in the recovery process. We should better understand these disorders to provide enhanced assistance and support to those in need.

References
APA (2020) Summary of Recommendations of the APA Guideline
Development Panel for the Treatment of PTSD.
APA (2020) Treatment Dose, Timing, and Duration as Described in Reviewed Studies.
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Wu, X., Kaminga, A. C., Dai, W., Deng, J., Wang, Z., Pan, X., & Liu, A. (2019).
The prevalence of moderate-to-high posttraumatic growth: A systematic review and meta-analysis. Journal of Affective Disorders, 243, 408-415. doi:10.1016/j.jad.2018.09.023.