PTSD: National Center for PTSD

Acute Stress Disorder

What is acute stress disorder (ASD)?

Like PTSD, acute stress disorder is a mental health problem that can occur following a traumatic event (or trauma). ASD is diagnosed if you have symptoms between 3 days and 1 month after the trauma. The symptoms impact your daily life and create distress.

There are 4 types of symptoms with acute stress disorder:

• Reliving the event (or intrusion). Memories of the traumatic event can feel real and come back at any time.
• Avoidance. Trying to avoid situations or people who are reminders of the event.
• Feeling keyed up (or arousal). Feeling jittery, on edge or on guard, or becoming easily irritated.
• Dissociation. Feeling disconnected from oneself or surroundings or feeling as if one is in a dream.

The symptoms of ASD overlap with PTSD, with a few exceptions. Both PTSD and acute stress disorder have 4 types of symptoms. Intrusion, avoidance, and arousal are similar for both. However, PTSD does not include dissociation in its core symptoms; instead, there is a dissociative subtype of PTSD. The other type of PTSD symptom (that is not included in ASD symptoms) is negative changes in thoughts and feelings since the trauma.

How common is acute stress disorder?

It can be difficult to know how many people have a diagnosis, like acute stress disorder. The best estimate comes from a meta-analysis, a study that combines data from many different research studies. Overall, within one month of a trauma, about 1 out of every 5 people (20%) will experience ASD.

ASD is more common for people who experience certain types of trauma. For example, those who experience violence (such as sexual violence, interpersonal violence, etc.) are more likely to develop ASD than those who experience disasters, serious accidents, war, or life-threatening illness.

Who is at risk for acute stress disorder?

Several factors can place you at higher risk for developing ASD after a trauma:

• Having gone through other traumatic events
• Experiencing violence (compared to other types of trauma)
• Having a history of PTSD
• Having a history of other mental health problems

Women are more likely to develop acute stress disorder, which is in part due to it being more common for them to experience interpersonal violence (such as sexual violence).

Does acute stress disorder predict PTSD?

Research has not shown that a diagnosis of ASD predicts whether someone will develop PTSD. Meaning, someone can develop ASD shortly after a trauma and not go on to have PTSD. Likewise, not everyone who develops PTSD had acute stress disorder prior.

How is acute stress disorder diagnosed and treated?

Most people have stress reactions after a trauma and recover in time and there are ways to cope and manage self-care after a trauma. When distress is high enough to impact daily life, talking to a health care provider is important. A mental health care provider trained in treatment for trauma can assess for ASD by asking questions about symptoms. Talk therapy known as cognitive behavioral therapy (CBT) has been shown to have positive results. If ASD is diagnosed, the provider can help someone decide whether CBT may be useful and together, make a treatment plan.

Summary

After a trauma, it is common for anyone to have stress reactions. When symptoms in the first month after the trauma create great levels of distress, it is important to talk with a mental health provider. The symptoms of acute stress disorder are similar to PTSD, but not the same. Cognitive behavioral therapy is an effective treatment for ASD.