Acute Stress Disorder

Acute Stress Disorder is a type of anxiety disorder characterized by a collection of dissociative and anxiety symptoms that usually occur within a month of exposure to an extreme traumatic stressor. A traumatic event can include anything from a serious threat to one’s life, or witnessing the death or serious injury of another person; to learning of the violent death or serious injury of a family member or close friend.

Acute Stress Disorder is a relatively new diagnostic category that was added into the Diagnostic and Statistical Manual in 1994 to differentiate short-term responses to trauma from long-lasting symptoms characteristic for Post-Traumatic Stress Disorder.1 Although it is sometimes misinterpreted as PTSD, ASD develops and subsides much more rapidly than symptoms of PTSD, generally lasting anywhere from two days to four weeks.

Symptoms of Acute Stress Disorder

Individual vulnerability and coping capacity play a vital role in the occurrence and severity of an acute stress reaction, as evidenced by the fact that not all people exposed to exceptional stress develop symptoms.

According to the Diagnostic & Statistical Manual, “the essential feature of Acute Stress Disorder is the development of characteristic anxiety, dissociative, and other symptoms that occurs within one month after exposure to an extreme traumatic stressor.”

Common symptoms that sufferers of acute stress disorder experience include, but are not limited to:

  • A subjective sense of numbing, detachment, or absence of emotional responsiveness.
  • Derealization: an alteration in perception leading to the feeling that the reality of the world has been changed or lost.
  • Depersonalization: An alteration in the perception or experience of the self where the person feels detached from his or her own mental processes or environment.
  • Dissociative amnesia: a mental condition where the individual blocks out certain information, usually associated with a stressful or traumatic event, leaving him or her unable to remember important personal information.
  • Hyperarousal or anxiety, including sleep problems, irritability, inability to concentrate, an unusually intense startle response, hypervigilance, and physical restlessness.
  • A marked tendency to avoid people, places, objects, conversations, and other stimuli reminiscent of the trauma.
  • Re-experiencing the trauma in recurrent dreams, images, thoughts, illusions, or flashbacks.

Treatment Options for Acute Stress Disorder

Generally, most types of anxiety disorders are responsive to counseling and/or a wide variety of psychotherapies.

Medications are usually limited to those necessary for treating individual symptoms. Clonidine is often prescribed to individuals who experience hyperarousal; and individuals who suffer from anxiety and panic attacks are often given propranolol clonazepam or alprazolam.3 Antidepressants may be prescribed if ASD progresses to PTSD.

A variety of different psychotherapies have also been proven to prevent ASD from progressing into PTSD. One variant of cognitive-behavioral therapy called psychoeducational therapy appears to be three to four times as effective as supportive therapy in preventing ASD from progressing to PTSD.

Group and family therapies also appear to help patients with ASD reinforce effective strategies for coping with the trauma, and may reduce the risk of social isolation as a reaction to the trauma. They give patients opportunities to describe what happened and how they responded; they also let patients receive warmth and caring from their listeners, and help put memories of the event into a coherent narrative, allowing them to integrate the trauma into their overall lives.

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