The DSM-IV specifies that<unk>  must be accompanied by the presence of dissociative symptoms, which largely differentiates it from post-traumatic stress disorder. Dissociative symptoms include a sense of numbing or detachment from emotional reactions, a sense of physical detachment such as seeing oneself from another perspective decreased awareness of one's surroundings, the perception that one's environment is unreal or dreamlike, and the inability to recall critical aspects of the traumatic event (dissociative amnesia). In addition to these characteristics,<unk>  can be present in the following four distinct symptom clusters; ; Intrusion symptom cluster Recurring and distressing dreams, flashbacks, and/or memories related to the traumatic event. Intense/prolonged psychological distress or somatic reactions to internal or external traumatic cues. ;Negative mood cluster A persistent inability to experience positive emotions such as happiness, loving feelings, or satisfaction. ;Avoidance symptom cluster The avoidance of distressing memories, thoughts, feelings (or external reminders of them) that are closely associated with the traumatic event. ;Arousal symptom cluster Sleep disturbances, hyper-vigilance, difficulties with concentration, easily startled, and irritability/anger/aggression. Potential Developments There are a number of issues that can arise from<unk>  stress. Depression, anxiety, mood disorders, and substance abuse problems can develop from<unk>  stress. Untreated<unk>  can also lead to the development of post-traumatic stress disorder.
Acute stress disorder
Adjustment disorder
Post-traumatic stress disorder
Complex post-traumatic stress disorder
Somatization disorder
Functional somatic syndrome
Prolonged grief disorder
Stress-related disorders