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When people experience a traumatic event, it can lead to all sorts of psychological problems. In this lesson, we’ll look at one reaction to trauma: acute stress disorder. We’ll examine the diagnostic criteria, risk factors, and treatments, and then test our knowledge with a quiz.

Acute Stress Disorder

Colleen has always been a little tense, but recently it’s gotten worse.

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A couple of weeks ago, she was walking down the street and witnessed a car wreck in which two people died. Since then, she feels like she’s in a daze and can’t seem to pay attention to what’s going on around her. She feels numb to everything; even visiting with her granddaughter doesn’t bring her joy.She keeps thinking about the wreck, and every time she closes her eyes, she can see the image of the people in the car dying. Even so, she can’t remember certain things, like what she was doing when the wreck happened or when the police and firefighters arrived at the scene. Colleen might be suffering from acute stress disorder, a psychological disorder that involves anxiety, dissociative, or other symptoms within one month of experiencing a traumatic event.

Acute stress disorder is similar to Post-Traumatic Stress Disorder, or PTSD, an anxiety disorder common in rape victims and combat veterans. However, for a psychologist to diagnose PTSD, the symptoms must have been present for more than a month, whereas acute stress disorder is diagnosed within the first month after the traumatic experience. Let’s look closer at acute stress disorder and how psychologists treat it.


Imagine that you are a psychologist and Colleen comes to see you. She really wants to get back to her normal routine, but she just can’t seem to let go of the accident that she witnessed.

You think that she might have acute stress disorder. To check, you run down a list of criteria that needs to be met for you to diagnose her.1.

Exposure to a traumatic event.An event is considered to be traumatic if there is a threat of death to the person or someone else, and if the person reacts with horror, helplessness, or fear. Colleen witnessed a car wreck, which took the lives of two people. At the time of the event, she felt scared and helpless, so yes, she was exposed to a traumatic event.

2. Three or more dissociative symptoms.Dissociative symptoms are when someone feels detached from his or her life. Examples of dissociative symptoms include feeling numb or emotionally unresponsive, feeling detached from the world around you, feeling like you’ve lost touch with reality, feeling like you’ve lost the sense of yourself as a person, and forgetting important aspects of the event.

Remember that Colleen is feeling like she’s in a daze, which is an example of being detached from the world around her. She also feels numb and can’t remember certain parts of the car wreck. These are all dissociative symptoms, so we can check this one off.3. Reliving the experience.

This can take many forms. It could simply mean that you’re thinking about the event over and over, or it could be as serious as having flashbacks. Colleen can’t stop thinking about the wreck, so she’s reliving the experience.

4. Avoiding things that remind the person of the event.People with acute stress disorder do not want to be reminded of the traumatic event, so they avoid conversations or situations that might remind them of it. For example, Colleen has stopped taking her daily walks, since that’s what she was doing when she witnessed the wreck.5. Symptoms of anxiety.This could be nervousness and tension, or just an increase in physiological arousal, like being restless or being constantly on the lookout for bad things to happen.

When you talk to Colleen, she says she hasn’t been sleeping well, which is a symptom of anxiety.6. It causes distress or impairment.Distress can be any type of negative emotional reaction, including anger or depression, and impairment means that you can’t function normally in some part of your life, including work and your social life. When Colleen talks to you, she’s visibly upset and even cries, so she’s experiencing distress.

7. Lasts a minimum of two days, a maximum of four weeks, and is within four weeks of the event.In other words, acute stress disorder occurs within a month of the event and lasts at least two days. Colleen has been feeling this way since the accident happened a couple of weeks ago, so she meets this criterion.8.

Cannot be explained by another mental or physical illness.There is no evidence that Colleen has another mental or physical ailment that could account for her symptoms.Since she meets all eight criteria, you can diagnose Colleen with acute stress disorder.

Causes and Treatment

Obviously, the cause of acute stress disorder is the stressor, or traumatic event. But many people may experience the same event and only some of them get acute stress disorder. What makes some people more likely to develop it than others?Studies have found a few risk factors that increase your likelihood of developing acute stress disorder after a traumatic event.

People who have gone through another traumatic event, for example, are more likely to develop ASD. In addition, someone who has had PTSD in the past is more likely to end up with acute stress disorder.It’s not just PTSD, though. People with a history of other mental health issues are also more at risk for acute stress disorder.

Remember that Colleen has always been a little tense. She might have an anxiety disorder, which would make her more vulnerable to acute stress disorder after the car wreck.Whatever the cause, as her psychologist, you’ll want to come up with a treatment plan to help Colleen move past the trauma and back to her normal level of functioning. Cognitive behavioral therapy, which focuses on changing a patient’s thoughts and behaviors, is particularly beneficial for acute stress disorder patients. Changing the way they think about the trauma can help them deal with it. In addition, antidepressants are sometimes prescribed for patients with acute stress disorder.

Lesson Summary

Acute stress disorder is a psychological disorder that involves an intense reaction to a traumatic situation within the first few weeks after the trauma. Among other symptoms, patients with acute stress disorder experience anxiety and dissociative symptoms. Risk factors include a history of mental illness, including post-traumatic stress disorder. Treatment includes therapy, including cognitive behavioral therapy and antidepressant medication.

Learning Outcomes

After completion of the lesson, you should be able to:

  • Identify and define the symptoms of acute stress disorder
  • Contrast the differences between acute stress disorder and PTSD
  • Understand the possible treatments for the disorder

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