Acute Stress Disorder

Acute stress disorder develops within one month after an individual experiences or sees an event involving a threat or actual death, serious injury, or physical violation to the individual or others, and responds to this event with strong feelings of fear, helplessness or horror.

The diagnosis was established to identify those individuals who would eventually develop post-traumatic stress disorder. As far back as World War I this condition was referred to as "shell shock," in which there are similarities between reactions of soldiers who suffered concussions caused by exploding bombs or shells and those who suffered blows to their central nervous systems. More recently, ASD was brought to light as it became clear that for a short period, people might exhibit PTSD-like symptoms immediately after a trauma.

Trauma has both a medical and a psychiatric definition. Medically, trauma refers to a serious or critical bodily injury, wound or shock. This definition is often associated with trauma medicine practiced in emergency rooms and represents a popular view of the term. Psychiatrically, trauma has assumed a different meaning and refers to an experience that is emotionally painful, distressful or shocking, which often results in lasting mental and physical effects.

Psychiatric trauma, or emotional harm, is essentially a normal response to an extreme event. It involves the creation of emotional memories about the distressful event that are stored deep within the brain.

In general, it is believed that the more direct the exposure to the traumatic event, the higher the risk for emotional harm. Thus in a school shooting, for example, the student who is injured probably will be most severely affected emotionally, and the student who sees a classmate shot or killed is likely to be more emotionally affected than the student who was in another part of the school when the violence occurred. But even secondhand exposure to violence can be traumatic. For this reason, all children and adolescents exposed to violence or a disaster, even if only through graphic media reports, should be watched for signs of emotional distress.

Acute Stress Disorder. Last reviewed 12/31/1969
  • Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
  • Anxiety and Its Disorders: The nature and treatment of anxiety and panic (Guilford Press)
  • Journal of Consulting and Clinical Psychology
  • American Journal of Psychiatry
  • Journal of Anxiety Disorders
  • Journal of Traumatic Stress
  • Journal of Clinical Psychiatry
  • War Psychiatry: Textbook of Military Medicine
  • Journal of the American Academy of Child and Adolescent Psychiatry
  • National Institute of Mental Health
  • National Center for PTSD
  • Department of Health & Human Services