Acute Stress Disorder

About Acute Stress Disorder

Acute stress disorder is a trauma and stressor related condition that develops after exposure to actual or threatened death, serious injury or sexual violence, with symptoms lasting from three days to one month after the event. Under DSM-5, a person has at least nine symptoms from five categories: intrusion, such as distressing memories, nightmares or flashbacks; negative mood; dissociation, such as an altered sense of reality or inability to remember parts of the event; avoidance of reminders; and arousal, such as sleep problems, irritability, poor concentration, hypervigilance and an exaggerated startle response. The diagnosis was introduced in DSM-IV in 1994, partly to identify people with significant distress soon after trauma, before PTSD can be diagnosed. Many people with acute stress disorder go on to develop PTSD, while others recover, and many people who later develop PTSD did not first meet criteria for acute stress disorder. Early responses after trauma typically focus on safety, practical support and psychological first aid. Trauma focused cognitive behavioral therapy in the weeks after trauma has the best evidence for people with acute stress disorder, while routine single session debriefing is not supported by research. Medication is sometimes used for specific symptoms such as severe sleep disturbance.