Acute Stress Disorder 

Understanding Acute Stress Disorder 

Acute stress disorder is a psychological condition that can occur as a response to experiencing or witnessing a traumatic event. It typically involves intense emotional and physical reactions that can significantly impact a person’s daily life. Understanding the nature of acute stress disorder and its triggers is crucial for recognizing and addressing its symptoms early on.

Acute stress disorder is characterized by symptoms that appear after a person experiences one or more traumatic events. Traumatic events that may cause acute stress disorder include:

• Sexual violence
• Physical attacks
• Being mugged
• Childhood abuse
• Kidnapping
• Hostage situations
• Terrorist attacks
• Torture
• Natural disasters (earthquakes, hurricanes, etc.)
• Accidents (car crashes, airplane crashes, industrial accidents, etc.) 

In most cases, illnesses and medical conditions do not cause acute stress disorder. However, they can also be a cause if they involve unexpected and extreme situations, such as waking up during surgery or experiencing severe allergic reactions.

However, it is also possible for acute stress disorder to develop after a person has witnessed a traumatic event. These events may include witnessing:

• Serious injury
• Unnatural death
• Violence
• Domestic violence
• War
• Serious medical emergencies involving loved ones

Symptoms of Acute Stress Disorder 

Although the symptoms of acute stress disorder may differ from person to person, they usually involve anxiety and re-experiencing of the traumatic event. Some individuals might primarily experience a sense of dissociation or detachment (feeling disconnected or separated for one’s surroundings), although they often also show strong emotional or physical reactions when reminded of the trauma. Others might react with significant anger, leading to irritability or even aggressive behavior.

Re-Experiencing of Traumatic Events

Frequent, unwanted memories of the traumatic event are a common way of re-experiencing. These recollections often appear unexpectedly and are caused by something that reminds the person of the trauma. These memories often involve various aspects:

• Sensory: Recalling the intense heat felt during a house fire.
• Emotional: Feeling the same fear as if one were about to be stabbed.
• Physiological: Experiencing the same shortness of breath felt during a near-drowning.

Dissociative States

Dissociative states can last from a few seconds up to several hours or even days. During these episodes, a person might relive aspects of the traumatic event and behave as if it is happening again in real-time.

For young children, a reenactment of the trauma may show up when they play with toys. This might include dissociative moments, such as a child who survived a car accident repeatedly crashing toy cars in a distressing way.

Physical and Psychological Distress

Some people might experience severe psychological and physical distress when they encounter triggers that remind them of past trauma. For example, a child might become very anxious on windy days if they have been through a hurricane, or someone who was assaulted in an elevator might react strongly when entering an elevator again.

It can also be difficult for individuals suffering from acute stress disorder to feel positive emotions. They might experience emotions such as sadness, anger, shame, or guilt more strongly and more persistently. 

Sleeping Problems 

People suffering from acute stress disorder may experience difficulty falling asleep or staying asleep. These issues can be linked to nightmares or a general sense of heightened alertness that makes it hard to get restful sleep. Those affected may also become easily irritable and may react with verbal or physical aggression with little provocation.

Depersonalization and Derealization

Depersonalization is the feeling of being detached from oneself. Individuals suffering from acute stress disorder may experience viewing themselves from a distance as if they were on the other side of the room. They may also experience derealization, perceiving themselves and their surroundings in a distorted way. For example, they may feel as if they were moving in slow motion, seeing things in a daze, or not processing events as they happen.

Prevalence of Acute Stress Disorder

The prevalence of acute stress disorder among people who have recently experienced trauma (within one month of the event) varies depending on the type of trauma and the context in which it is assessed. In both United States and international populations, acute stress disorder is generally identified in less than 20% of cases following traumatic events that do not involve interpersonal assault. For example, it occurs in about 13%-21% of motor vehicle accidents, 14% of mild traumatic brain injuries, 19% of assaults, 10% of severe burns, and 6%-12% of industrial accidents.

A study from 2018 also stresses that acute stress disorder varies depending on the type of traumatic event. However, the study also notes that the rates of acute stress disorder differ significantly across different studies. This is influenced by the differences in how acute stress disorder is diagnosed and the low number of participants. 

Progression of Acute Stress Disorder 

Acute stress disorder cannot be diagnosed until 3 days after a traumatic event. While it may develop into posttraumatic stress disorder (PTSD) after 1 month, it can also be a temporary stress response that resolves within that month and does not lead to PTSD.

An article published in 2017 explains that most children and adolescents with acute stress disorder after a trauma show significant recovery within two to three months. The article states that acute stress disorder is only a moderate predictor of PTSD. It is also notable that some children with PTSD never suffered from acute stress disorder. 

Similarly, a paper from 1999 investigated how acute stress disorder evolves over time in traffic accident victims. The paper explains that only some of the victims developed PTSD. According to the paper, the first three months after the accident are the most vital in the progression of PTSD. If the symptoms of the individual worsen in this period, they are at a greater risk of developing PTSD. 

Because of these factors, both studies stress the importance of monitoring acute stress disorder early, preventing the potential progression to PTSD. 

Risk Factors for Acute Stress Disorder

Temperamental 

Temperamental risk factors for developing acute stress disorder include:

• Having a prior mental health condition
• Neuroticism (experiencing high levels of negative emotions)
• Perceiving the traumatic event as severe
• Avoidant coping styles (avoiding stressful situations, experiences, and thoughts) 
• Exaggerated fears of future harm
• Feelings of guilt and hopelessness

Moreover, a study from 2013 also identifies poor sleep, high stress, and use of psychiatric medication as possible risk factors for the development of acute stress disorder. These traits were also associated with a greater severity of acute stress disorder. 

Environmental

Environmental factors play a significant role in the risk of developing acute stress disorder. Most importantly, an individual must have been exposed to a traumatic event to be at risk. Additionally, having a history of previous trauma increases the likelihood of developing the disorder.

Genetic and Physiological Factors

Individuals who show heightened reactivity, such as being easily scared or startled by loud noises, are at a greater risk of developing acute stress disorder after exposure to trauma. 

Culture and Acute Stress Disorder

The symptoms of acute stress disorder can vary significantly across different cultures, especially in terms of dissociative symptoms, nightmares, avoidance behaviors, and physical symptoms like dizziness, shortness of breath, and heat sensations.

Cultural beliefs and distress expressions shape how acute stress disorder is perceived and expressed in various communities. In the first month after trauma, some cultural groups may exhibit dissociative responses such as possession or trance-like behaviors. 

In Cambodians, for example, panic symptoms may be prominent due to the link between traumatic experiences and panic-like khyâl attacks. Similarly, in Latin American cultures, the condition known as ataque de nervios might occur after a traumatic event.

Gender and Acute Stress Disorder

Acute stress disorder is more commonly found in females than in males. This higher prevalence in females may be partly due to sex-linked neurobiological differences in how stress is processed. Additionally, females are more likely to experience certain types of traumatic events, such as sexual assault and other forms of interpersonal violence, which carry a higher risk of developing acute stress disorder.

Moreover, a paper published in the American Journal of Psychiatry studied the development of acute stress disorder in women and men following a traffic accident. The paper found that women are more likely than men to develop both acute stress disorder and PTSD. Specifically, 23% of females were diagnosed with acute stress disorder compared to 8% of males, and 38% of females developed PTSD compared to 15% of males. The paper suggests various factors influencing acute stress disorder between genders, including biological differences and societal factors.

The Impact of Acute Stress Disorder 

Issues with normal functioning in social, interpersonal, or work-related areas are common among survivors of accidents, assaults, and sexual assault who develop acute stress disorder. The intense anxiety often associated with this disorder can disrupt sleep, lower energy levels, and make it difficult to focus on tasks.

An article from 2005 discusses the impact of acute stress disorder on the quality of life in adolescents who suffer serious injuries. According to the article, acute stress disorder significantly decreases the quality of life over the long term, lasting up to 24 months after the injury. Importantly, individuals who suffered violence-related injuries were more likely to develop acute stress disorder.

Furthermore, a 2021 study examined how acute stress disorder impacts the quality of life of individuals who experienced a violent crime. The study found that individuals who develop acute stress disorder after such an event experience a significant decline in their physical health, psychological well-being, social relationships, and overall environment. If acute stress disorder develops to PTSD, then these areas experience further deterioration. Crucially, the study suggests that social support may minimize these negative effects. Because of this, the individual needs to receive support immediately after the traumatic event. 

Cognitive Behavioral Therapy (CBT) for Acute Stress Disorder

A paper published in 2003 examines the long-term benefits of using CBT for the treatment of acute stress disorder. The article claims that if the patients received CBT therapy shortly after their trauma, they were less likely to develop PTSD. These patients also experienced less severe symptoms compared to patients who received other treatments, such as supportive counseling. Crucially, four years after receiving the treatment, only 8% of those who received CBT met the criteria for PTSD, compared to 25% in the supportive counseling group.

Similarly, another paper from 1999 also evaluates the effectiveness of CBT and supportive counseling in trauma survivors. The paper claims that CBT is significantly more effective than supportive counseling in preventing the progression of acute stress disorder to PTSD. Six months after treatment, only 15-23% of patients who received CBT developed PTSD, compared to 67% of those who received supportive counseling. However, CBT was also effective in reducing avoidance behaviors (avoiding stressful situations, experiences, and thoughts), a significant symptom of PTSD. 

CBT can thus not only have significant benefits in the treatment of acute stress disorder but may also prevent PTDS. However, it is important to implement CBT as quickly as possible after the traumatic event since this may increase the potential benefits. 

 How The Sintelly App Can Help 

When dealing with acute stress, the app’s interactive chatbot can be a lifeline. Available at any time, the chatbot provides a safe space to express your thoughts and emotions, offering immediate support and helping to reduce feelings of isolation. Whether you’re dealing with anxiety, intrusive thoughts, or physical symptoms, the chatbot is there to listen and respond with empathy.

To further assist with managing symptoms, Sintelly provides a variety of Cognitive Behavioral Therapy (CBT) exercises tailored to address specific aspects of acute stress disorder. These exercises guide you through practical techniques to challenge and reframe negative thoughts, manage anxiety, and build resilience. After completing each exercise, the app delivers personalized insights based on your input, helping you gain a deeper understanding of your stressors and how to handle them more effectively.

Sintelly also includes a psychodiagnostic test that gives you a comprehensive look at your mental health. This test identifies key areas affected by acute stress disorder, providing a clearer picture of where your focus is needed. The app then translates these results into visual graphs, making it easy to track your progress over time. These visual representations help you see tangible evidence of your improvement, motivating you to continue your recovery journey.

Through its combination of empathetic communication, tailored exercises, diagnostic insights, and progress tracking, Sintelly equips you with the tools you need to move forward with confidence.