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What is Acute Stress Disorder, Acute Stress Reaction?

Acute stress disorder and acute stress response are reactions to trauma. Learn the causes, criteria, and who is susceptible to acute stress disorder.

Acute stress disorder and acute stress reaction can develop in anyone in response to direct exposure to a traumatic event. A traumatic event is an event so threatening to the core of someone’s sense of self and the world that it overwhelms his/her ability to cope.

When humans face traumatic events such as severe accidents, threatened or actual violence, natural or human-made disasters, or exposure to war, automatic reactions are survival-based. Along with emotional and physical responses to trauma, people seek to process and understand events and figure out how they fit into their life picture.

Sometimes, however, the trauma responses aren’t adaptive. Rather than moving forward, the person remains stuck in the trauma. When this happens, a person experiences an acute stress reaction or acute stress disorder.

Criteria for Acute Stress Disorder

Among the defining criteria for Acute Stress Disorder established in the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5), three are prominent criteria:

  1. Exposure to a traumatic event/stressor that involves actual or threatened death, serious injury, or sexual violation and causes specific symptoms
  2. The symptoms must begin within three days of the event (a diagnosis can’t be given until day three) and must last more than three days but subside within one month
  3. Symptoms must cause distress or impairment.

Exposure to a traumatic event or extreme stressor means that the person was present at the time of the trauma and either directly experienced harm or witnessed firsthand (as opposed to on the news or social media) the trauma occurring to others.

A person may also be diagnosed with acute stress disorder if he/she learns that a family member or close friend experienced a violent or accidental trauma. Further, acute stress disorder can be diagnosed in people who experience repeated exposure to details of traumatic events, again, in person rather than through media.

What is Acute Stress Reaction?

Acute stress reaction isn’t a diagnosable disorder but is a short-term response to a traumatic event. Acute stress reaction begins immediately at the time of the event and lasts up to two- to three days.

Anxiety and depression are widespread in acute stress reactions. Additionally, acute stress reaction can include withdrawal, narrowing of attention to the event and outcomes of it, disorientation, despair, hopelessness, grief, anger, and/or heightened arousal.

Who is Susceptible to Acute Stress Disorder?

Anyone can have an acute stress reaction or develop acute stress disorder after a traumatic event. That said, there are certain factors that increase someone’s risk. These include:

  • Severity and type of trauma (traumatic events that are human-induced, violent, and/or intentional are more likely to lead to a trauma disorder than are natural disasters or accidents)
  • Inadequate support systems
  • Past trauma
  • Pre-existing mental illness
  • Substance use/abuse
  • Degree of functioning prior to the trauma
  • Recent stressful life experiences/changes
  • Meaning one assigns to the traumatic event
  • Belief that more harm will continue
  • Negative effect like anxiety, depression, anger, guilt, hopelessness, etc.
  • Unhelpful coping skills
  • High levels of pain
  • Being female

The prevalence of acute stress disorder hasn’t been determined with certainty. The percentage of people who develop acute stress disorder after a traumatic event varies according to the event, and even these percentages don’t have a high degree of reliability due to the current lack of a uniform method of gathering data. Very general statistics indicate that for human-induced violent traumas, over 20 percent of people develop acute stress disorder. Acute stress disorder isn’t rare.

Acute stress disorder can be all-consuming, negatively impacting someone’s entire life. Acute stress disorder isn’t a weakness; it’s a reaction to an external trauma. Acute stress disorder is treatable, and people can live fully again.


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next: Acute Stress Disorder Symptoms
~ all articles on acute stress disorder
~ all articles on ptsd and stress disorders

Last Updated: 04 October 2016
Reviewed by Harry Croft, MD

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