Acute stress disorder
Acute stress disorder is a trauma-triggered symptom cluster of intrusion, avoidance, negative mood or cognition, and hyperarousal that begins within 1 month of a life-threatening event and lasts 3 days to 1 month; symptoms lasting beyond 1 month become posttraumatic stress disorder. First-line treatment is trauma-focused cognitive behavioral therapy, with pharmacotherapy usually reserved for prominent anxiety or persistent symptoms.
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What this article covers
- Overview
A time-locked trauma reaction, not a chronic illness by definition: acute stress disorder is the symptom cluster that follows direct experience of, witnessing of, or learning that a close family…
- Epidemiology
Follows the epidemiology of trauma exposure itself: the disorder occurs only after a life-threatening event, so its occurrence tracks the same exposures documented for PTSD: military service…
- Risk factors
Life-threatening trauma exposure is the prerequisite risk factor: without direct experience, witnessing, or learning that a life-threatening event happened to a close family member or friend, the diagnosis cannot be made.
- Pathophysiology
This is a psychological response to trauma exposure rather than a specific neurobiological mechanism for acute stress disorder: the same trauma-response framework used for PTSD, intrusive…
- Clinical features
Exposure requirement: direct experience of, witnessing, or learning that a close family member or friend experienced a life-threatening event (serious injury, sexual assault, war, or comparable trauma).
- Differential diagnosis
Posttraumatic stress disorder: requires the identical trauma exposure and symptom domains, but symptoms must persist beyond 1 month and meet a higher threshold of six or more symptoms across the…
- Diagnosis
The diagnosis is clinical and rests on the time window: acute stress disorder is diagnosed when trauma exposure is followed by one or more symptoms from the intrusion, avoidance, negative…
- Management
First action is trauma-focused cognitive behavioral therapy (CBT): begin trauma-focused CBT as the best initial treatment, addressing emotional processing of the trauma, maladaptive thought patterns…
- Complications
Progression to posttraumatic stress disorder: this window, symptoms present 3 days to 1 month after trauma, is the period during which early, adequate trauma-focused CBT can help prevent progression…
- Prognosis
Time-limited by definition when it resolves within the window: symptoms that remit before the 1-month mark constitute a completed episode of acute stress disorder rather than an evolving chronic illness.
- Prevention
Early trauma-focused CBT within the acute window is the preventive measure against progression to PTSD: initiating trauma-focused therapy during the 3-day-to-1-month acute stress disorder window…
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Related articles
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