page_title: Incident stress
section_title: Causes
hierarchical_section_title: Incident stress / Causes
caption_attribution_description: English: Medical emergency in the street of Belgrade
context_page_description: Incident stress is a condition caused by acute stress which overwhelms a staff person trained to deal with critical incidents such as within the line of duty for first responders, EMTs, and other similar personnel. If not recognized and treated at onset, incident stress can lead to more serious effects of posttraumatic stress disorder.
context_section_description: 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 among 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 post traumatic stress disorder (PTSD).
  People exhibiting signs of incident stress require professional help to avoid the more serious condition of posttraumatic stress disorder. 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 psychological reactions someone goes through after the critical event has occurred. Those includes nightmares, reoccurring 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.
caption: Emergency workers must respond quickly to incidents. Incident stress can occur immediately while a worker is still on the scene, or manifest at a later time.
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