Acute stress disorder (ASD) is a short-term mental health condition that can occur within the first month after experiencing a traumatic event. It involves stress responses, including:
- Anxiety
- Intense fear or helplessness.
- Experiencing flashbacks or nightmares.
- Feeling numb or detached from one’s body.
- Avoiding situations, places or other reminders related to the traumatic event.
Examples of traumatic events include:
- Natural disasters, such as a tornado, fire or flood.
- Sexual assault.
- Physical assault.
- Verbal abuse.
- Witnessing bodily harm or death.
- Serious accidents, such as a car accident.
- Experiencing a severe injury or sudden illness.
- War.
Acute stress disorder can affect a person at any stage of life — childhood, adolescence and adulthood.
What’s the difference between acute stress disorder and PTSD?
The main difference between acute stress disorder and Post-Traumatic Stress Disorder is the length of the symptoms.
Acute stress disorder involves stress reactions that happen between three days and four weeks following a traumatic event. Stress reactions lasting longer than four weeks may meet the criteria for PTSD.
The American Psychiatric Association first classified acute stress disorder as a mental health diagnosis in 1994 in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
What’s the difference between adjustment disorder and acute stress disorder?
Adjustment disorder is a mental health condition that happens in response to a stressful life event. The emotional and behavioral symptoms are generally considered more intense than what would be expected for the type of event that occurred.
The difference between acute stress disorder and adjustment disorder is that the stressful event in adjustment disorder (such as losing your job or the ending of a relationship) is typically less traumatic than an event that causes acute stress disorder (such as sexual assault or surviving a mass shooting).
How common is acute stress disorder?
It’s difficult for researchers to assess how common acute stress disorder is. This is partly because people may not seek professional help until their symptoms meet the criteria for PTSD.
According to various studies, the prevalence of acute stress disorder following a traumatic event may range from 6% to 33%. The rates also differ for different types of trauma. For example, survivors of accidents or natural disasters show lower rates of ASD. Survivors of violence, such as assaults and mass shootings, show higher rates of ASD.
Symptoms and Causes
What are the symptoms of acute stress disorder?
Symptoms of ASD are psychological and behavioral stress responses. They may include:
- Recurring, uncontrollable and distressing memories of the event.
- Recurring nightmares.
- Flashbacks of the traumatic event.
- Intense psychologic or physical distress when you’re reminded of the event.
- Persistent difficulty feeling positive emotions, such as happiness, contentment or loving feelings.
- An altered sense of reality, like feeling you’re in a daze or as if time is passing in slow motion.
- Memory loss regarding important aspects of the traumatic event.
- Efforts to avoid distressing memories, thoughts or feelings associated with the event.
- Efforts to avoid external reminders associated with the event (people, places or things).
- Disturbed sleep.
- Irritability or anger outbursts.
- Excessive attention to the possibility of danger (hypervigilance).
- Difficulty concentrating.
- An exaggerated response to loud noises, sudden movements or other stimuli (startle reflex).
What causes acute stress disorder?
It’s unclear why people respond differently to traumatic events.
One theory involves the concept of “fear conditioning.” This happens when your body exhibits a fear response to certain stimuli associated with a traumatic event. For example, if you were in a car accident and you had fast food in your vehicle and it was nighttime, future encounters with the smell of fast food at night may trigger your body to have the same fear response that you did during the traumatic event even though there’s no threat to your safety.
Some people may adapt to fear conditioning via extinction learning, which involves a gradual reduction in response to the traumatic triggers. If this doesn’t work, you could develop acute stress disorder and potentially PTSD.
What are the risk factors for acute stress disorder?
Acute stress disorder risk factors may include:
- History of prior mental health condition(s) (including prior trauma).
- Catastrophic worry.
- Avoidant coping style.
- Minimal support system.
What are the complications of this condition?
The main complication of acute stress disorder is the potential development of post-traumatic stress disorder (PTSD). PTSD may develop if acute stress disorder isn’t treated.