Like post-traumatic stress disorder (PTSD), acute stress disorder is a condition marked by increased stress and anxiety following a traumatic or stressful event. A person can be diagnosed with acute stress disorder if exposed to actual or threatened death, serious injury, or sexual violence in one or more of the following ways:

• Directly experiencing the traumatic event(s).
• Witnessing, in person, the event(s) occur to others.
• Learning that a violent or accidental traumatic event(s) occurred to a close family member or close friend.
• Experiencing repeated or extreme exposure to adverse details of the traumatic event (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).
• Duration of symptoms less than 1 month.

Symptoms of Acute Stress Disorder

A diagnosis of acute stress disorder requires significant distress or impairment in social, occupational, or other important areas of functioning for at least 3 days and up to one month. Symptoms are required in nine or more of the following five categories of intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred.

Intrusion Symptoms

• Recurrent, involuntary and intrusive distressing memories of the traumatic event(s). (In children, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.)
• Recurrent distressing dreams related to the event(s). (In children, there may be frightening dreams without recognizable content).
   Flashbacks in which the individual feels or acts as if the traumatic event(s) are recurring.
• Intense or prolonged psychologic distressed or marked physiological reactions in response to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
• Negative Mood
• Persistent inability to experience positive emotions, such as happiness, satisfaction, or loving feelings.

Dissociative Symptoms

• An altered sense of the reality of one’s surroundings or oneself.
   Inability to remember an important aspect of the traumatic event(s).

Avoidance Symptoms

• Avoidance of distressing memories, thoughts or feelings closely associated with the traumatic event(s).
• Avoidance of people, places, objects and situations that arouse distressing memories, thoughts or feelings closely associated with the traumatic event.

Arousal Symptoms

• Sleep disturbance, such as restlessness or difficulty falling/staying asleep.
• Irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or physical aggression toward people or objects
• Hypervigilance
• Problems with concentration
• Exaggerated startle response