Acute stress disorder is characterized by the development of severe anxiety, dissociation, and other symptoms that occurs within one month after exposure to an extreme traumatic stressor (e.g., witnessing a death or serious accident). As a response to the traumatic event, the individual develops dissociative symptoms. Individuals with acute stress disorder have a decrease in emotional responsiveness, often finding it difficult or impossible to experience pleasure in previously enjoyable activities and frequently feel guilty about pursuing usual life tasks.
A person with acute stress disorder may experience difficulty concentrating, feel detached from their body, experience the world as unreal or dreamlike, or have increasing difficulty recalling specific details of the traumatic event (dissociative amnesia).
In addition, at least one symptom from each of the symptom clusters required for posttraumatic stress disorder is present. First, the traumatic event is persistently re-experienced (e.g., recurrent recollections, images, thoughts, dreams, illusions, flashback episodes, a sense of reliving the event, or distress when exposed to reminders of the event). Second, reminders of the trauma (e.g., places, people, activities) are avoided. Finally, hyperarousal in response to stimuli reminiscent of the trauma is present (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, an exaggerated startle response, and motor restlessness).
Specific Symptoms of Acute Stress Disorder:
Acute stress disorder is most often diagnosed when an individual has been exposed to a traumatic event in which both of the following were present:
- The person experienced, witnessed, or was confronted with (e.g., can include learning of) an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others.
- Though not required, the person’s response is likely to involve intense fear, helplessness, or horror.
Either during or following the distressing event, the individual has 3 or more of the following dissociative symptoms:
- A subjective sense of numbing, detachment, or absence of emotional responsiveness
- A reduction in awareness of his or her surroundings (e.g., “being in a daze”)
- Dissociative amnesia (i.e., inability to recall an important aspect of the trauma)
The traumatic event is persistently re-experienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or distress when exposed to reminders of the traumatic event.
Acute stress disorder is also characterized by significant avoidance of stimuli that arouse recollections of the trauma (e.g., avoiding thoughts, feelings, conversations, activities, places, people). The person experiencing acute stress disorder also has significant symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness).
For acute stress disorder to be diagnosed, the problems noted above must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual’s ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience.
The disturbance in an acute stress disorder must last for a minimum of 3 days and a maximum of 4 weeks, and must occur within 4 weeks of the traumatic event. Symptoms also can not be the result of substance use or abuse (e.g., alcohol, drugs, medications), caused by or an exacerbation of a general or preexisting medical condition, and can not be better explained by a a brief psychotic disorder.
This disorder has been updated according to DSM-5 criterion