Family survived the sinking of "Costa Concordia".

Acute stress disorder (ASD) was introduced into DSM-IV to describe acute stress reactions (ASRs) that occur in the initial month after exposure to a traumatic event and before the possibility of diagnosing posttraumatic stress disorder (PTSD), and to identify trauma survivors in the acute phase who are high risk for PTSD. The recommendation to shift ASD and PTSD out of the anxiety disorders section reflects increased recognition of trauma as a precipitant, emphasizing common etiology over common phenomenology. PTSD is an anxiety disorder precipitated by exposure to an event that involves actual or threatened death or serious injury, or threat to the personal integrity of self or others that causes intense fear, helplessness, or horror. Typical post-trauma symptoms are re-experiencing some aspects of the trauma, avoidance of trauma-related stimuli, numbing, and increased arousal. Post-traumatic syndrome differs from the majority of other diagnostic categories as it includes in its criteria the presumptive cause of the trauma (criterion A). PTSD can be acute (1-3 months duration of symptoms), chronic (more than 3 months in duration), or delayed (symptoms appear at least 6 months after the trauma). The diagnosis requires that the onset of the symptoms or re-experiencing, avoidance, numbing, and arousal be related to exposure to the traumatic event. The DSM-IV divides the 17 symptoms of PTSD into tree clusters: re-experiencing of the trauma (e.g. intrusive thoughts, nightmares, flashbacks, and emotional or physiological reactivity with reminders), avoidance/ numbing of trauma reminders (e.g. avoidance of thoughts, conversations, activities, feeling, individuals or places that are reminders, inability to recall portions of the trauma, decreased interest in pleasurable activeties, detachment or estrangement from others, restricted affect and foreshortened future) and arousal (e.g. sleep problems, irritability and anger, hypervigilance, difficulty concentrating and exaggerated startle). The diagnosis of PTSD may prove to have several subtypes, depending upon such factors as the developtmental phase during which the trauma occurred, presence or absence of impulsive dyscontrol, specific symptom profile (including dissociative symptoms), comorbidity, or pre-existing psychiatric disorder. Different etiopathogenic models propose to account for the PTSD 's heterogeneous appearance and instability with time. The comorbidity concept sees the PTSD as an independent entity other independent pathologies coexist with. The typologic concept suggests that the PTSD is an independent entity which shows different clinical appearances based on symptommatic descriptions. The "cascade" concept suggests to see the PTSD as an independent entity which offers, with time, different symptomatic appearances, in evolution, because of events caused by after effects, in different areas of the PTSD itself. The recommendation to shift ASD and PTSD out of the anxiety disorders section in DSM-5 reflects increased recognition of trauma as a precipitant, emphasizing common etiology over common phenomenology.