Acute Stress Disorder or ASD - Symptoms and Treatment

by Kathleen R. Madison, MRC, CRC, LPCI

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Finding help quickly is a wise choice for individuals who have experienced a traumatic event. Most people will encounter a traumatic event in their lifetime and one fourth of these individuals will develop Acute Stress Disorder (Understanding Abnormal Behavior, p.158).

Acute Stress Disorder, also called ASD, demonstrates the development of characteristic anxiety, dissociative, and other symptoms that occur within 1 month after exposure to an extreme traumatic stressor. This usually involves a direct personal experience of an event and may have actual or threatened death or serious injury, or other threat to one’s physical integrity. Witnessing an event that involves death, injury, or a threat to the physical integrity of another person can also cause Acute Stress Disorder. Learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate is also another essential feature of Acute Stress Disorder.  Individuals in combat situations, people who have been battered and/or sexually assaulted are all likely to experience Acute Stress Disorder. Rape is another ‘traumatic event” that can result in ASD. In one instance, 74% of the victims of rape met the criteria for ASD and 3 months later, 35% met the criteria for PTSD (Valentine, Foa, Riggs, Gershuny, 1996). Finding help is important as left unchecked, Acute Stress Disorder could progress to Post-Traumatic Stress Disorder. It is believed that some fragile individuals can suffer a trauma reaction by just witnessing a television image.

In the available studies, it has been found that from 14% to 33% of individuals who have been exposed to severe trauma have been found to have Acute Stress Disorder (DSM-IV-TR pg. 463). You may experience a feeling of hopelessness, or overwhelming despair in which case it is wise to consider whether or not you are depressed. Impulsivity and risk-taking behavior is often present after the trauma has been experienced. Because of some of the symptoms of Acute Stress Disorder, you may not even realize that you are experiencing a residual affect of the trauma; you may not want to talk about it to anyone. You may think you have processed the trauma, but, in reality, you may be unable to recognize that you do need professional help in working through the incident.

At least three of the following dissociative symptoms must be present while experiencing the traumatic event, or after the event: 

  • a subjective sense of numbing, detachment, or absence of emotional responsiveness;
  • ‘being in a daze';
  • derealization;
  • depersonalization;
  • or dissociative amnesia which is the inability to recall an important detail of the trauma.

Following the trauma, the traumatic event is persistently reexperienced and lasts for a minimum of 2 days and a maximum of 4 weeks after the traumatic event.

People who suffer from Acute Stress Disorder find it difficult to be emotionally responsive. They no longer find pleasure in activities they once enjoyed and often feel guilty about pursuing usual life tasks. It is difficult to concentrate when you are experiencing Acute Stress Disorder. You may even feel detached from your body, or think that your world is unreal or dreamlike. People often lose recollection of details surrounding the traumatic event which is called dissociative amnesia. Perhaps you are persistently reexperiencing the event through flashbacks, or dreams, or thoughts that recur. Maybe you avoid places or people or activities that remind you of the traumatic event. You might have difficulty sleeping, or concentrating, and you may be irritable or have an exaggerated startle response. There may be agitation or overactivity (a flight reaction of fugue). Sweating and flushing are often present and perhaps signs of panic anxiety may also be demonstrated.

Finding help is important as left unchecked, Acute Stress Disorder could progress to Post-Traumatic Stress Disorder.  What is the difference between Acute Stress Disorder and PSTD? ASD differs in that there are more dissociative symptoms (numbing, reduced awareness, depersonalization, derealization, or amnesia). Acute Stress Disorder is the immediate reaction to trauma. If left untreated, it could develop into PTSD. Cognitive behavioral interventions have proven quite successful in the treatment of Acute Stress Disorder. Because there is no closure in a tragedy or traumatic event, a caring, trusted, and trained professional counselor is the best equipped individual to help a victim process the clinical symptoms and profound feelings of Acute Stress Disorder.

Kathleen R. Madison, MRC, CRC, LPCI