Acute stress disorder refers to the aftereffects someone experiences following an intense event where the person believed that they were witnessing a serious threat to their life or someone else’s, or when they or someone close to them experienced a serious injury, accident, or violent physical encounter or death. This diagnosis is similar to a more commonly known disorder, post-traumatic stress disorder, but has some different criteria.
When someone experiences a severe or traumatic event in their life, they can begin to develop disruption in their mental health and overall functioning. Mental health professionals describe these mental, physiological, and emotional changes using a variety of descriptions based on what the person identifies experiencing.
Causes of Acute Stress Disorder
Acute stress disorder typically results from exposure to actual or threatened death, serious injury, or sexual violation in one (or more) of the following ways:
- Directly experiencing traumatic events
- Witnessing, in person, traumatic events that occurred to others
- Learning that the events occurred to close family members or friends. In cases of actual or threatened death of a family member or friend, the event must have been violent or accidental
- Experiencing repeated or extreme exposure to unpleasant details of traumatic events
Those suffering from acute stress disorder tend to include people who have experienced or witnessed serious car accidents, violent assaults, shootings, or other situations that they perceive as being highly dangerous.
Symptoms of Acute Stress Disorder
The Diagnostic and Statistical Manual of Mental Health Disorders (DSM-V) describes acute stress disorder as requiring the presence of nine or more of the following symptoms from any of five distinct categories, including:
Intrusion
- Recurrent, involuntary, and intrusive distressing memories of the traumatic events
- Recurrent distressing dreams related to the events
- Flashbacks in which the one feels as if they are experiencing the traumatic events
- Intense or prolonged psychological distress or marked physiological reactions in response to internal or external cues that symbolize or resemble an aspect of the traumatic events
Negative Mood
This refers to the persistent inability to experience positive emotions such as joy, satisfaction, and love and can damage close relationships.
Dissociation
- An altered sense of the reality of one’s surroundings or oneself (e.g., seeing oneself from another’s perspective, being in a daze, time slowing).
- Inability to remember an important aspect of the traumatic events
Avoidance
- Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic events
- Efforts to avoid external reminders that arouse distressing memories, thoughts, or feelings about or are closely associated with the traumatic events
Arousal
- Sleep disturbance
- Irritable behavior and angry outbursts
- Hypervigilance
- Difficulty concentrating
- Exaggerated startle response
Like all mental health disorders in the DSM-V, a person can only be diagnosed with acute stress disorder if they meet the above criteria and the symptoms cause clinically significant problems in the person’s life; this means that the above symptoms need to cause impairment in the social, occupational, educational, or other important areas of their life. For acute stress disorder, the symptoms need to present sometime between 3 days and 1 month after being exposed to the traumatic experience, and cannot be attributed to a substance dependency or any other mental health issues.
The Difference Between Acute Stress Disorder and PTSD
The symptoms of acute stress disorder echo the symptoms of PTSD, as this condition is the short-term result of experiencing a traumatic event, and PTSD is the longer-term result. To meet the criteria for PTSD, a person must continue to have symptoms in four areas: intrusive symptoms, negative mood symptoms, avoidance symptoms, and hyperarousal symptoms, for longer than one month. Untreated acute stress disorder symptoms can evolve into PTSD and can persist for long periods and affect a person severely if not addressed by a mental health professional.
Treatment Options for Acute Stress Disorder
Mental health professionals usually recommend psychotherapy, often in the form of cognitive behavioral therapy or exposure therapy, and medication, such as antianxiety medications and antidepressants. The course of treatment selected is subject to the severity of the symptoms and the medical and mental health history of the patient.
For those experiencing acute stress disorder, it’s recommended to consult with a mental health professional and begin addressing the symptoms before they seriously impair one’s daily functioning.
Sources
- What is Posttraumatic Stress Disorder (PTSD)? (n.d.). https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
- Graham, J., Legarreta, M., North, L. W., DiMuzio, J., McGlade, E., & Yurgelun‐Todd, D. (2016). A Preliminary study of DSM–5 PTSD symptom patterns in Veterans by Trauma type. Military Psychology, 28(2), 115–122. https://doi.org/10.1037/mil0000092
- Bryant, R. A., Harvey, A. G., Dang, S. T., & Sackville, T. (1998). Assessing acute stress disorder: Psychometric properties of a structured clinical interview. Psychological Assessment, 10(3), 215–220. https://doi.org/10.1037/1040-3590.10.3.215
- Bryant, R. A., Creamer, M., O’Donnell, M. L., Silove, D., & McFarlane, A. C. (2008). A multisite study of the capacity of acute stress disorder diagnosis to predict posttraumatic stress disorder. The Journal of clinical psychiatry, 69(6), 923–929. https://doi.org/10.4088/jcp.v69n0606
- Bryant, R. A., Friedman, M. J., Spiegel, D., Ursano, R., & Strain, J. (2011). A review of acute stress disorder in DSM-5. Depression and anxiety, 28(9), 802–817. https://doi.org/10.1002/da.20737
- Fanai, M., & Khan, M. A. (2023, July 10). Acute stress disorder. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK560815/
Dr. Shannon McHugh is a Licensed Clinical and Forensic Psychologist in Los Angeles, California. She specializes in assessment and treatment of children, adolescents, and adults who have developmental and social delays, behavioral difficulties, and those who have experienced traumatic events