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Acute Stress Disorder

Last updated April 4, 2018

Approved by: Maulik P. Purohit MD, MPH

David Castillo Dominici - FreeDigitalPhotos.net

Acute Stress Disorder (ASD) is characterized by the onset of dissociative and anxiety symptoms.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Acute Stress Reaction
  • Mental Shock
  • Psychological Shock

What is Acute Stress Disorder? (Definition/Background Information)

  • Acute Stress Disorder (ASD) is characterized by the onset of dissociative and anxiety symptoms occurring within a month of a traumatic event
  • Typically, the traumatic event has provoked an intense feeling of fear, sadness, and/or helplessness. The more directly an individual is exposed to the  event, the higher the risk of psychological damage
  • Acute Stress Disorder emerges soon after the event, and its effects take place rapidly. Dissociative symptoms (being numb, less aware of the surroundings, and sense of being dissociative from self) are the distinguishing factors that an individual may have Acute Stress Disorder, and not post-traumatic stress disorder (PTSD)
  • In order to diagnose Acute Stress Disorder, there must be a clear connection between the traumatic event and the development of symptoms
  • A type of psychotherapy, called cognitive behavioral therapy (CBT), has been shown to have positive results for those with Acute Stress Disorder. With effective psychological treatment and a good support system, the prognosis of ASD is very good
  • If left unresolved, there is high chance that Acute Stress Disorder might progress and evolve into PTSD

Who gets Acute Stress Disorder? (Age and Sex Distribution)

  • Acute Stress Disorder occurs in individuals exposed to an exceptionally traumatic event
  • It may occur in any age group or gender; no racial or ethnic predilection is also observed

What are the Risk Factors for Acute Stress Disorder? (Predisposing Factors)

Individuals who are at an increased risk of Acute Stress Disorder are:

  • Being exposed to a highly traumatic event
  • Experiencing PTSD in the past
  • Being diagnosed with prior mental health problem
  • Perception: Those who feel themselves (inappropriately) responsible for the event, personalizing the trauma, and/or having generally pessimistic attitudes are more likely to develop Acute Stress Disorder
  • Prior exposure: Individuals, who experienced trauma as children, are more likely to develop ASD

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acute Stress Disorder? (Etiology)

The primary cause of Acute Stress Disorder is exposure to a traumatic event.

  • Humans undergo biological changes when confronted with an intense stimulus. When extreme fear is felt, an individual’s primal instinct drives them towards survival (surviving through the situation). The heart rate and blood pressure increase, muscles tense up, and breathing gets faster during one’s response to a traumatizing event
  • After the event, various stimuli may trigger a ‘flashback’ to the event, causing the initial symptoms to occur, thus, leading to extreme hyperarousal rather than anxiety
  • Natural disasters (hurricanes, floods, and earthquakes) or accidents (car crashes) are less traumatic than events where one individual intentionally harms another. There is a significantly higher rate of Acute Stress Disorder and post-traumatic stress disorder in survivors of a terrorist-inflicted trauma

What are the Signs and Symptoms of Acute Stress Disorder?

The symptoms of an Acute Stress Disorder must be present within a month of exposure to a highly traumatic event and usually last for several days. The symptoms presented should not have been caused by substance abuse or a general medical condition.

The signs and symptoms of Acute Stress Disorder include:

  • Feeling numb, detached, or less aware of surroundings
  • De-realization (altered perception)
  • Depersonalization: Sense of being dissociative from self
  • Re-experiencing the trauma through dreams, images, or flashbacks
  • Conversely, avoidance of people, places, and other stimuli that trigger thoughts of the event
  • Hyperarousal or anxiety
  • Insomnia
  • Survivor's guilt

How is Acute Stress Disorder Diagnosed?

Acute Stress Disorder is a relatively new disorder that was added to the DSM (Diagnostic and Statistical Manual of Mental Disorders) to clarify time-specific trauma reactions from long-term effects caused by post-traumatic stress disorder (PTSD). It is also used to identify those individuals at risk for PTSD.

  • In order to diagnose Acute Stress Disorder, there must be a clear connection between the traumatic event and the development of symptoms
  • Symptoms usually develop within a few minutes, but may take up to a month to fully develop
  • Symptoms should resolve within a month of exposure to the stressor (an agent or event causing the stress)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.           

What are the possible Complications of Acute Stress Disorder?

Complications of Acute Stress Disorder include the following:

  • Post-traumatic stress disorder is a possibility, when Acute Stress Disorder is not treated effectively
  • Daily life may become hard for the individual if they are constantly reminded of the traumatic event
  • Those suffering from a traumatic event may resort to alcohol or other substances to alter their mental state in a way that allows them to forget or "numb" their emotional pain

How is Acute Stress Disorder Treated?

A treatment of Acute Stress Disorder may include the following:

Cognitive behavioral therapy (CBT): It is a type of psychotherapy that has shown positive results in those affected by Acute Stress Disorder.

  • CBT's goal is to primarily alter maladaptive thinking patterns in regards to the event. The individual's behavior must also be changed in accordance to the new way of thinking
  • A new thinking pattern, in addition to behavior, will allow the individual to cope with future stressful situations and/or triggers of the initial event
  • Those who are treated through CBT, soon after the trauma, are less likely to show post-traumatic stress disorder symptoms later
  • The chance of developing PTSD after cognitive-behavioral therapy is only about 20%, in comparison to the 80% without therapy

Medications may also be used; however, their usefulness is limited to treating only specific symptoms of the disorder such as:

  • Clonazepam for panic attacks and anxiety
  • Trazodone for insomnia
  • Fluoxetine for avoidance

How can Acute Stress Disorder be Prevented?

  • Generally, the traumatic event itself cannot be prevented. However, the time-frame taken by the exposed individual to begin to cope with the event is important for recovery and eliminating the onset of post-traumatic stress disorder
  • If the affected individual analyzes the event, addresses their feelings with respect to it, and constructs a healthy plan to cope in a timely manner with the situation, then positive results are very likely
  • Some individuals also benefit from describing their traumatizing experience several times to those they are really attached or close to
  • The probability of healthy recovery significantly increases with the strong support system of friends and family as well

What is the Prognosis of Acute Stress Disorder? (Outcomes/Resolutions)

  • With effective psychological treatment and a good support system, the prognosis of Acute Stress Disorder is generally good
  • If left unresolved or untreated, Acute Stress Disorder is more than likely to progress into post-traumatic stress disorder

Additional and Relevant Useful Information for Acute Stress Disorder:

  • The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association is the most commonly used reference among mental health professionals. It contains diagnostic criteria, research findings, and treatment information for a wide variety of mental disorders
  • Post-traumatic stress disorder (PTSD) is a syndrome characterized by “re-experiencing” a traumatic event, and it includes a decreased responsiveness and avoidance of any event associated with the trauma

The following article link will help you understand post-traumatic stress disorder:


What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 17, 2015
Last updated: April 4, 2018