Acute stress disorder: symptoms, causes and treatment

Acute stress disorder involves exposure to a traumatic event or event, And causes a series of intrusive, dissociative and avoidance symptoms, causing severe discomfort to the sufferer.

It lasts between 3 days and 1 month, and if symptoms persist, it eventually progresses to PTSD (post-traumatic stress disorder). In this article, we will know the main symptoms of this disorder, the causes behind it and the treatments used.

    Acute stress disorder: features

    Acute Stress Disorder (ASD) is a disorder classified as a “trauma and stressor disorder” in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders).

    It is a short form of PTSD (Post Traumatic Stress Disorder); thus, while PTSD lasts at least 1 month, ASD lasts at least 3 days and at most 1 month. In other words, that is to say when symptoms last longer than a month, ASD becomes PTSD.


    The diagnostic criteria for acute stress disorder in DSM-5 are as follows.

    1. Exposure to death, serious injury or sexual violence

    The first criterion includes exposure to such a shocking and traumatic event as death, serious injury or sexual violence. It can be experienced in a real way or as a threat.

    The forms of exposure include four varieties or situations: it can be a direct experience in fact, being present at the event that has happened to another, knowing that the event has happened to a family member, or to a close friend, or that we have been exposed to disgusting details of the event on several or extremely occasions.

    The latter case details would include professions such as police and firefighters, among others, as they are frequently exposed to death, violence and child abuse, for example.

      2. Various symptoms

      The second criterion for acute stress disorder includes the presence of 9 symptoms (or more) from 5 categories, namely: intrusion, negative mood, dissociation, avoidance and alertness. Symptoms start or worsen after the traumatic event or events.

      Let’s look at the 5 categories of symptoms:

      2.1. intrusion

      It includes memories of the event itself; these memories are intrusive and involuntary, as well as painful and recurring (they repeat themselves). In children, however, instead of memories, games may appear that somehow express parts of the traumatic event.

      Recurring dreams may also appear success or part of it, dissociative reactions and significant psychological discomfort.

      2.2. Negative mood

      Another notable symptom in acute stress disorder is the inability to feel positive feelings or emotions.

      2.3. dissociation

      Additionally, an altered sense of reality or ego may appear, as well as an inability to remember the event itself or a part of it.

      2.4. avoidance

      The person with acute stress disorder he tries to avoid remembering or thinking about the event, and goes to great lengths to achieve it; it also avoids remembering people, objects or conversations related to the event (i.e. external reminders of the event).

      2.5. alert

      The fifth category of symptoms includes trouble sleeping, irritable or angry behavior, hypervigilance, trouble concentrating, and exaggerated startle responses.

      the causes

      As we have seen, the causes of acute stress disorder are exposure (in one of its variants) to a traumatic and shocking event or event, related to death (e.g. suicide, fatal accident or murder).), A serious event injuries (eg being seriously injured after an accident) and sexual violence (eg rape).

      In other words, that is to say the event must be of a certain seriousness and very shocking to the person who experiences, hears or sees it. Thus, the causes may be the same as those that cause PTSD.


      Psychological treatment for acute stress disorder understands trauma exposure techniques. These are usually techniques that include in their strategies imagination training and covert (imaginary) exposure, although live exposure can also be used, especially for details, objects or people related to the scene. ‘event.

      In addition, strategies are often used to get the patient to write or express the story of the event, which includes all possible details, to later rework that story or writing to include reassuring, relaxing, or positive elements. The aim is for the patient to treat in a healthy way what he has experienced or the event to which he has been exposed in one way or another.

      Another technique used for acute stress disorder is cognitive restructuring, Which eliminates or modifies cognitive distortions and negative and / or catastrophic thoughts caused by the traumatic experience.

        pharmacological treatment

        Regarding psychopharmacological treatment, anti-anxiety drugs can be used in addition to psychological intervention, To relieve the most physiological and anxious symptoms of the person.

        However, we must keep in mind that acute stress disorder lasts a maximum of 1 month, and therefore is not as long as prolonging the duration of the pharmacological prescription; sometimes no medication will even be prescribed, it all depends on what the doctor or psychiatrist says after a thorough assessment of the person.

        Bibliographical references:

        American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana. Belloch, A .; Sandín, B. and Ramos, F. (2010). Manual of psychopathology. Volumes I and II. Madrid: McGraw-Hill. Pérez, M .; Fernandez, JR; Fernández, C. and Amic, I. (2010). Guide to effective psychological treatments I and II :. Madrid: Pyramid.

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