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Acute Stress Disorder

Acute Stress Disorder is characterized by the
development of severe anxiety, dissociative,
and other symptoms that occurs within one
month after exposure to an extreme traumatic
stressor (e.g., witnessing a death or serious
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
A person with Acute Stress Disorder may
experience difficulty concentrating, feel
detached from their bodies, 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
reexperienced (e.g., recurrent recollections,
images, thoughts, dreams, illusions, flashback
episodes, a sense of reliving the event, or
distress on exposure 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
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 an event or events
that involved actual or threatened
death or serious injury, or a threat to
the physical integrity of self or others
The person's response involved intense
fear, helplessness, or horror
Either while experiencing or after experiencing
the distressing event, the individual has 3 or
more of the following dissociative symptoms:
A subjective sense of numbing,
detachment, or absence of emotional
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
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 on
exposure 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 2 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.