1. ACUTE STRESS REACTIONa. DSM IV Diagnostic criteriai. Person has been exposed to a traumatic event, which both of the following were present1. Person experienced, witnessed or confronted with life threatening or injury causing events of self or others2. Persons response involved intense fear, helplessness, horrorii. Individual has three (or more) of symptoms while or after experiencing event1. Subjective sense of numbing, detachment or absent emotional responsiveness2. Reduce awareness to surroundings3. Derealisation4. Depersonalization 5. Dissociative amnesia (unable to recall important aspect of trauma)iii. Event is persistently re-experienced 1. Recurrent images2. Thoughts3. Dreams4. Illusions5. Flashback episodes6. Sense of reliving experience7. Distress on exposure to reminders of the eventiv. Avoidance of stimuli that arouse recollection of trauma (thoughts, feelings, activities, places, people)v. Marked symptoms of anxiety or increased arousal (sleeping difficulties, irritability, poor concentration)vi. Disturbance causes impairment in social, occupational or other abilities to pursue some necessary taskvii. Disturbance lasts minimum 2 days, maximum 4 weeks, occurs within 4 weeks of traumatic eventb. Symptomsi. Emotional1. Intense anxiety2. Restlessness3. Insomnia4. Panic attacks5. Depersonalisation6. Derealisationii. Somatic1. Palpitation2. Sweating3. Tremoriii. Dissociative1. Numbing2. Difficulty in recall stressful events3. Being in daze4. Flashbacksc. Coping strategiesi. Avoid reminders of stressful eventsii. Avoid social contactsiii. Maladaptive coopingiv. Release emotion through histrionic or aggressive behaviour (deliberate self- harm, excessive alcohol drinking)d. Managementi. Reduce emotion1. Sympathetic listening2. Short term anxiolyticsii. Encourage recall of eventsiii. Help with more effective copingiv. Help with residual problem2. ADJUSTMENT DISORDERSa. DSM IV Criteriai. Development of emotional or behavioural symptoms in response to identifiable stressor(s) occurring within 3 months of stressor(s) onsetii. Symptoms or behaviour clinically significant, evidenced by one or both of the following;1. Marked distress that is out of proportion to severity or intensity of stressor2. Significant impairment in social, occupational, or other important areas of functioningiii. Stress relate disturbances does not meet criteria for another mental disorder and not merely an exacerbation of a pre-existing mental disorderiv. Symptoms do not represent normal bereavementv. Once stressor or its consequences have terminated, symptoms do not persist for more than additional 6 monthsb.