Acute Stress Disorder (ASD): Symptoms, Causes, Diagnosis and Treatment

Acute Stress Disorder (ASD) occurs after a traumatic event when individuals experience intense psychological responses that disrupt daily life and persist beyond the initial shock.  When individuals experience or witness an intense event—such as a natural disaster, accident, or assault—they develop ASD within the first few days or weeks after exposure. Understanding ASD and its impact is important, especially given that about 20–90% of individuals experience severe trauma at some point. However, only a small percentage, about 1.3% to 11.2%, of those exposed to such events go on to develop serious conditions like Acute Stress Disorder (ASD), according to a study by Fanai M, Khan MAB. et al. 2023, titled “Acute Stress Disorder.”

The symptoms of ASD are intense and are both psychological and physical, including flashbacks, nightmares, and severe anxiety. Individuals with ASD experience disorientation, memory gaps, and emotional numbness, which interfere with daily activities and interpersonal relationships. People with ASD show signs of hypervigilance and heightened startle responses, placing them in a continuous state of mental health alert. These symptoms are important for clinicians to identify, as ASD is commonly misdiagnosed or overlooked due to similarities with other conditions, such as adjustment disorder. An early and accurate diagnosis makes a significant difference in managing symptoms and preventing the transition from ASD to Posttraumatic Stress Disorder.

Risk factors for ASD include a history of mental health conditions, previous exposure to trauma, and genetic or biological predispositions. People with a history of mental illness have around 3 times the risk of showing signs of ASD after experiencing a new traumatic event, according to a study by Worku A et al. 2022, titled “Acute stress disorder and the associated factors among traumatized patients admitted at Felege-Hiwot and the University of Gondar comprehensive specialized hospitals in Northwest Ethiopia.” Other factors, such as age and gender, influence ASD risk; studies indicate that women and younger individuals are more prone to developing ASD after trauma, with 23% of women meeting the full criteria for ASD, compared to 8% of men, according to a study by the National Center for PTSD titled “Research on Women, Trauma, and PTSD.”

Diagnosis for ASD includes following standardized criteria for assessing symptoms within a month of trauma exposure. Tools like the Immediate Stress Reaction Checklist and the Clinician-Administered PTSD Scale are employed to determine the frequency, intensity, and impact of ASD symptoms. Given ASD’s potential progression to PTSD, early intervention is important, which is why healthcare providers emphasize timely assessment and screening, particularly for high-risk individuals.

The treatment for ASD involves trauma-focused cognitive behavioral therapy (CBT), which has shown effectiveness in alleviating symptoms of ASD and preventing long-term complications. Partial Hospitalization Programs and Outpatient Rehabilitation Programs provide structured, supportive environments for individuals struggling with ASD. These therapy options allow patients to process trauma and develop coping mechanisms in a supervised setting. In cases where symptoms are severe, additional treatments, including medication and Therapy, are recommended to help stabilize the individual’s mental state. 

What is Acute Stress Disorder (ASD)? 

Acute Stress Disorder (ASD) is a mental health condition that arises in response to a traumatic event, lasting from 3 days to up to 4 weeks, according to a study by Fanai M, Khan MAB. et al. 2023, titled “Acute Stress Disorder.” ASD involves symptoms such as intense fear, helplessness, or horror, similar to those found in PTSD but with a shorter duration. Individuals with ASD experience anxiety, intrusive memories, and dissociation following a trauma.

Acute Stress Disorder (ASD) is disabling. ASD impacts daily functioning due to symptoms like severe anxiety, dissociation, and hypervigilance, which interfere with work and relationships. Although ASD is temporary, if it continues for more than 4 weeks, it meets the criteria for post-traumatic stress disorder (PTSD), according to a study by Fanai M, Khan MAB. et al. 2023, “Acute Stress Disorder.”

Unlike a syndrome, which is a collection of symptoms without a clearly defined onset or duration, Acute Stress Disorder (ASD) has specific diagnostic criteria that include symptoms emerging soon after trauma exposure (severe anxiety, dissociation, and intrusive memories) and lasting within a specified timeframe. This structured onset and limited duration make ASD distinct, allowing for a clear diagnosis and treatment plan based on how quickly the symptoms appear and how they manifest following a traumatic event.

In the International Classification of Diseases, Tenth Revision (ICD-10), the code for ASD is F43.0, classified under “Reaction to severe stress and adjustment disorders.” According to the DSM-5, ASD falls under Trauma- and Stressor-Related Disorders and is characterized by nine or more symptoms from five categories: intrusion, negative mood, dissociation, avoidance, and arousal, within the first-month post-trauma as mentioned by the American Psychiatric Association.

 Acute Stress Disorder (ASD) prevalence rates are recorded within a week after injury at about 24.0% to 24.6%, according to research by Ophuis RH et al. 201, titled “Prevalence of post-traumatic stress disorder, acute stress disorder, and depression following violence-related injury treated at the emergency department: a systematic review.” This prevalence shifted between 11.7% to 40.6% for cases assessed one to two weeks after injury. Another meta-analysis by Wenjie Dai et al. 2018, focused on individuals involved in road traffic accidents, found an overall ASD prevalence of 15.81%.

In the DSM-5, the F-code corresponding to ASD aligns with ICD codes but varies by specific classification systems. ASD lasts from 3 days to 4 weeks post-trauma. If symptoms persist beyond this timeframe, the diagnosis shifts to PTSD.

Common assessment tools for ASD include the Acute Stress Disorder Scale (ASDS) and the Stanford Acute Stress Reaction Questionnaire (SASRQ), which evaluate symptom severity and provide insight into trauma-related psychological impact.

What are the Symptoms of Acute Stress Disorder? 

The common symptoms of Acute Stress Disorder (ASD) include intense psychological reactions to a traumatic event, such as severe anxiety, dissociation, and intrusive memories. These acute symptoms emerge shortly after trauma exposure and significantly affect mental health by disrupting normal functioning. Individuals with ASD experience psychological and behavioral symptoms that interfere with their daily lives.

The main psychological and behavioral symptoms of ASD are explained below:

Psychological Symptoms of Acute Stress Disorder

Psychological symptoms of ASD are intense, overwhelming responses to trauma. They are severe and make coping with daily life difficult as they interfere with mental well-being. 

Common examples of psychological symptoms of Acute Stress Disorder (ASD) are as follows:

• Intrusive memories consist of recurring, involuntary flashbacks of the traumatic event.
• Excessive worry, restlessness, and tension following trauma.
• Feeling detached from oneself or one’s surroundings is known as an “out-of-body” experience.
• Distressing dreams that replay the trauma.
• Heightened awareness and sensitivity to surroundings, including feeling on edge.

Behavioral Symptoms of Acute Stress Disorder

Behavioral symptoms involve actions and reactions stemming from trauma, affecting interactions with others and daily routines. These symptoms are intense and create significant disruptions. 

Common examples of behavioral symptoms of Acute Stress Disorder (ASD) are as follows:

• Staying away from reminders of the trauma, including places or people associated with the event.
• Uncharacteristic anger or frustration without clear provocation.
• Difficulty falling or staying asleep due to stress and anxiety.
• Isolating from friends, family, and social activities.
• Engaging in risky behaviors as a coping mechanism.

What are the Causes of Acute Stress Disorder (ASD)?

The common causes of Acute Stress Disorder (ASD) include exposure to severe trauma, such as experiencing or witnessing a life-threatening event, a serious accident, or violence. These traumatic experiences overwhelm an individual’s ability to cope, leading to intense acute stress responses that interfere with mental health. 

In addition to the traumatic event itself, factors like previous traumatic events or preexisting risk factors for stress sensitivity contribute to the development of ASD. Anxiety and mood symptoms are found in 50–70% of children and adults with ASD, according to a study by Bruin EI de et al. 2007, titled “High rates of psychiatric co-morbidity in PDD-NOS.”

The common causes of Acute Stress Disorder are as follows:

• Exposure to a traumatic event: A sudden, overwhelming event like a serious accident or assault directly impacts mental health and triggers Acute Stress Disorder (ASD). According to a study by  Psychiatry.org titled “What is Posttraumatic Stress Disorder (PTSD)?” Acute Stress Disorder (ASD) affects 19% to 50% of individuals who experience severe interpersonal violence such as rape, assault, or intimate partner violence. 
• Witnessing trauma: Observing life-threatening situations induces acute stress similar to that experienced by direct victims, particularly if the person has close emotional ties to those affected.
• Preexisting mental health conditions: Individuals with prior mental health issues, such as anxiety or depression, have increased susceptibility to ASD, as they have a heightened sensitivity to stress and trauma. A study by Taylor JL, Gotham KO. et al. 2016, titled “Cumulative life events, traumatic experiences, and psychiatric symptomatology in transition-aged youth with autism spectrum disorder,” showed that nearly 90% of youth with ASD and clinical-level mood symptoms reported at least one trauma, compared to 40% of those without mood symptoms.
• Previous trauma history: Experiencing multiple traumatic events over time compounds the effects of new trauma, increasing the likelihood of ASD. A study by Worku A., Tesfaw G., Getnet B., et al. 2022, titled “Acute stress disorder and the associated factors among traumatized patients admitted at Felege-Hiwot and the University of Gondar comprehensive specialized hospitals in Northwest Ethiopia” found that individuals with a history of trauma were about 3.5 times more likely to develop Acute Stress Disorder (ASD) than those without previous trauma exposure. 
• Personality traits: Certain personality traits, such as high neuroticism or a tendency to react strongly to stress. High neuroticism elevates ASD risk by reducing an individual’s resilience to acute trauma, according to a study by Uliaszek AA et al. 2010, titled “The role of neuroticism and extraversion in the stress-anxiety and stress-depression relationships.”

What Risk Factors Contribute to Acute Stress Disorder (ASD)? 

The risk factors that contribute to Acute Stress Disorder (ASD) include the severity of the traumatic event, age and developmental factors, and gender. Each of these factors significantly increases the likelihood of developing ASD following a traumatic event.

The risk factors that contribute to Acute Stress Disorder (ASD) are as follows:

• Exposure to chronic stress: Prolonged exposure to stressors, such as ongoing workplace pressure or family conflict, diminishes an individual’s coping mechanisms, making them more susceptible to acute stress responses following a traumatic event. This chronic stress sensitizes individuals to future traumatic experiences.
• Severity of the traumatic event: The nature and severity of the trauma significantly impact the likelihood of developing ASD. Events involving extreme physical harm or threats to life, such as natural disasters or severe accidents, tend to produce more intense stress responses.
• Personal history of substance abuse: Individuals with a history of substance abuse have compromised mental health and coping strategies, making them more vulnerable to developing ASD when faced with trauma. Substance use exacerbates stress responses and hinders recovery efforts, according to a study by the National Institute on Drug Abuse titled “Trauma and Stress.”
• Age and developmental factors: Younger individuals or those in specific developmental stages experience trauma differently, impacting their vulnerability to ASD. For example, children and adolescents having less developed coping skills lead to higher susceptibility to stress-related disorders, according to a review article by the International Journal for Science and Research Hematology titled “Stress and Coping in Adolescents: A Review of the Literature.” 
• Gender differences: The probability of developing ASD is higher in females due to biological and social factors, including hormonal influences and societal expectations regarding emotional expression and coping. Women have a 2 to 3 times higher risk of developing post-traumatic stress disorder (PTSD) compared to men, as studied by Olff M. et al. 2017, titled “Sex and gender differences in post-traumatic stress disorder: an update.”

What are the Effects of Acute Stress Disorder (ASD)?  

The effects of Acute Stress Disorder (ASD) include physical, psychological, behavioral, and cognitive disturbances that significantly impact an individual’s daily functioning and overall well-being. These effects manifest shortly after experiencing a traumatic event and vary in severity and duration.

The effects of acute stress disorder (ASD) are as follows:

• Physical effects of Acute Stress Disorder (ASD): Physical effects refer to the bodily reactions that arise due to the stress response triggered by trauma. These effects range from mild to severe and have long-lasting implications on health. These effects are both short-term and long-term, particularly if not addressed through intervention. The common examples of physical impacts of Acute Stress Disorder (ASD) are as follows:
  • Increased heart rate
  • Headaches
  • Fatigue
  • Muscle tension
  • Gastrointestinal issues
• Psychological effects of Acute Stress Disorder (ASD): Psychological effects encompass the emotional and mental health challenges that emerge following trauma. These effects severely disrupt a person’s emotional equilibrium. It mostly has short-term effects but can develop into chronic conditions if not treated. The common examples of psychological impact of Acute Stress Disorder (ASD) are as follows:

• Intense anxiety
• Depression
• Irritability
• Emotional numbing
• Feelings of hopelessness
• Behavioral effects of Acute Stress Disorder (ASD): Behavioral effects of Acute Stress Disorder (ASD) are changes in actions or habits that arise due to the psychological impact of trauma. They alter interpersonal relationships and day-to-day functioning. These behavioral effects of Acute Stress Disorder (ASD) persist if coping strategies are not implemented. The common examples of behavioral effects of Acute Stress Disorder (ASD) are as follows:

• Avoidance of reminders of the trauma
• Increased substance use
• Withdrawal from social interactions
• Changes in sleep patterns
• Decreased work or school performance
• Cognitive effects of Acute Stress Disorder (ASD): Cognitive effects of Acute Stress Disorder (ASD) pertain to how trauma influences thought processes, including memory and concentration. These effects significantly impair cognitive functioning. The cognitive effects of Acute Stress Disorder (ASD) are both short-term and long-term, requiring therapeutic intervention to resolve. The common examples of cognitive effects of Acute Stress Disorder (ASD) are as follows:

• Difficulty concentrating
• Intrusive thoughts about the trauma
• Memory lapses
• Negative thought patterns
• Dissociation or feelings of detachment

How is Acute Stress Disorder (ASD) Diagnosed? 

Acute stress disorder is commonly diagnosed through various methods, including self-assessment quizzes, clinical evaluation by a mental health professional, diagnostic criteria from the DSM-5, structured clinical interviews, and psychological assessments and screening tools. 

To diagnose Acute Stress Disorder (ASD), the following methods are employed:

1. Self-Assessment Quizzes

These include tools like the Acute Stress Disorder Scale (ASDS) or the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5), which consist of questionnaires aimed at helping individuals identify symptoms related to acute stress. Their purpose is to provide preliminary insights into the presence of ASD symptoms and guide individuals toward seeking further professional evaluation.

2. Clinical Evaluation by a Mental Health Professional

Licensed professionals, such as psychologists or psychiatrists, conduct comprehensive assessments to identify symptoms of Acute Stress Disorder (ASD) and their severity. This method involves gathering detailed personal history and context regarding the traumatic event, which is important for understanding the individual’s experience and tailoring treatment options.

3. Diagnostic Criteria from the DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) outlines specific criteria for diagnosing ASD. To meet the DSM-5 criteria, patients must have experienced direct or indirect exposure to a traumatic event and present at least nine symptoms from any of the five categories (intrusion, negative mood, dissociation, avoidance, and arousal) for a duration of 3 days to 1 month.

4. Structured Clinical Interviews

These standardized interviews are conducted by trained clinicians who follow a specific format to collect comprehensive information on symptoms of Acute Stress Disorder (ASD) and functioning. This method ensures that all relevant areas, such as emotional and cognitive functioning, are thoroughly explored, aiding in a clear understanding of the individual’s condition.

5. Psychological Assessments and Screening Tools

Common tools such as the Clinician-Administered PTSD Scale (CAPS) or the Impact of Events Scale (IES) are employed to measure the severity of ASD symptoms and their impact on daily life. These assessments provide quantitative data that supports the diagnosis and tracks symptom changes over time, allowing for adjustments in treatment strategies.

What are the Treatment Options for Acute Stress Disorder (ASD)?  

The treatment options for Acute Stress Disorder (ASD) include various therapeutic approaches, inpatient and outpatient rehabilitation programs, and medication aimed at alleviating symptoms and promoting recovery. 

The common treatments for Acute Stress Disorder (ASD) are as follows:

Therapy

Therapies are focused on helping individuals process the traumatic event and develop coping strategies for their symptoms. The preferred treatment for Acute Stress Disorder (ASD) is trauma-focused Cognitive Behavioral Therapy (CBT), specifically tailored to address trauma. This therapy is delivered online, in person, or by phone and aims to educate patients on trauma psychology, teach symptom management skills, and identify cognitive distortions. Trauma-focused CBT therapy is delivered over 12–20 sessions lasting 60–90 minutes each and is suitable for children and adolescents aged 3 to 18 years, as studied by Cohen JA, Mannarino AP, Deblinger E., et al. 2016, titled “Treating trauma and traumatic grief in children and adolescents.”

Trauma-focused CBT uses exposure therapy—a method that involves gradual, controlled exposure to the trauma source to help reduce its impact. Exposure therapy is the standard for treating both ASD and PTSD, although a temporary increase in symptoms occurs, similar to other treatment methods.

Evidence demonstrates that Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is highly effective for treating Acute Stress Disorder (ASD) in children and adolescents when rigorously tested across multiple settings (homes, schools, foster care, and residential facilities) to improve accessibility. Clinical studies involving over 900 youths have included 16+ randomized controlled trials (RCTs), which were presented in a survey by Syros I et al. 2022, titled “ Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Cognitive Behavioral Intervention on Trauma in Schools (CBITS), and Other Promising Practices in the Treatment of Post-Traumatic Stress Disorder in Children and Adolescents: Evidence Evaluation.” The study presented the follow-up results showing sustained improvement in PTSD, anxiety, and depression symptoms up to two years post-treatment, according to a study

Debriefing is also a therapy that involves discussing the trauma in detail within the first 72 hours. It is widely available but is recommended only sometimes. Crisis intervention is another approach focusing on discouraging maladaptive coping mechanisms like alcohol use. The study by Hamm MP et al. 2010, titled “A systematic review of crisis interventions used in the emergency department: recommendations for pediatric care and research,” highlights that crisis intervention in emergency settings significantly reduces the need for hospitalization and shortens hospitalization stay times. Specifically, adults treated by crisis intervention teams were 41% less likely to be hospitalized compared to those receiving standard care. 

Partial Hospitalization Programs

Partial hospitalization programs provide intensive, structured treatment while allowing patients to return home in the evenings. These programs combine therapy, education, and support, which are particularly effective for individuals with severe symptoms that interfere with daily functioning. 

Partial Hospitalization Programs (PHPs) demonstrate notable effectiveness in treating Acute Stress Disorder (ASD) by significantly reducing symptom severity and enhancing cognitive functioning in a short duration. According to a study by Lieberman PB, Villalba R 2nd, Farris SG. et al. 2017, titled “Outcomes of Acute Partial Hospital Treatment: Comparison of Two Programs and a Waiting List Control,” patients admitted to two types of acute PHPs (mean stay of 5.3 days) showed moderate to substantial improvements across symptoms like anxiety, depression, hopelessness, and resilience. These improvements were consistent across different therapeutic approaches (cognitive-behavioral vs. interpersonal psychotherapy), suggesting that PHPs produce meaningful benefits for ASD patients within a week. Additionally, improvements in the PHP groups were notably greater than those observed in patients on a waiting list, underscoring the potential of PHP as an effective short-term intervention for ASD.

Outpatient Rehabilitation Programs

Outpatient rehabilitation allows individuals to receive ongoing support while maintaining their daily routines while staying at their home. This option involves regular therapy sessions and skills training to manage symptoms of Acute Stress Disorder (ASD). 

A study by Matthijssen SJ et al. 2024, titled “The effects of an intensive outpatient treatment for PTSD,” showed promising results, indicating the effectiveness of outpatient rehabilitation programs for treating Acute Stress Disorder. Among the 146 participants, significant reductions in stress symptoms were noted. About 52.4% of patients no longer met the ASD/PTSD diagnostic criteria after one month of treatment in an outpatient program. Additionally, 73.9% showed improvement based on the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) scale, while 77.6% improved according to the PTSD Checklist for DSM-5 (PCL-5), the two standardized assessment tools used to evaluate symptoms of Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorders (ASD). 

Medications

Medications, including Selective Serotonin Reuptake Inhibitors (SSRIs) and other antidepressants, are prescribed to manage severe symptoms of ASD. Among the SSRIs used by clinicians, Sertraline has been found to be the most productive and well-tolerated in the treatment of Acute Stress disorder, with only 8% of individuals discontinuing therapy due to adverse events compared to 10% for those on a placebo. 

The PANDA study by Lewis G. et al. 2019 titled “The Clinical Effectiveness of Sertraline in Primary Care and the Role of depression severity and Duration (PANDA): A Pragmatic, double-blind, Placebo-controlled Randomized Trial” explored the effectiveness of Sertraline (commonly known as Zoloft),  in patients aged 18 to 74 years across 179 primary care surgeries in the UK. The study indicated that sertraline has notable improvements in anxiety, quality of life, and self-rated mental health among participants within 12 weeks. 

Mindfulness and Relaxation Techniques

Mindfulness and relaxation techniques, such as meditation and deep-breathing exercises, help individuals manage stress and anxiety related to ASD. These techniques promote emotional regulation and reduce physiological arousal. A study by Goldsmith RE et al., “Mindfulness-Based Stress Reduction for Posttraumatic Stress Symptoms: Building Acceptance and Decreasing Shame,”  found that approximately 90% of the reduction in stress-related symptoms occurred within the first 3 sessions of mindfulness-based stress reduction training. 

Can Acute Stress Disorder Recurrence Occur?

Yes, Acute Stress Disorder (ASD) can occur again. Individuals who have experienced trauma are at a higher risk for developing ASD after subsequent traumatic events. A study by Schock, K et al. 2016, titled “Impact of new traumatic or stressful life events on pre-existing PTSD in traumatized refugees: results of a longitudinal study,” found that prior trauma exposure significantly increased the likelihood of experiencing ASD symptoms following new traumatic incidents. Specifically, individuals with a history of trauma had an elevated risk, with odds ratios suggesting they were up to 3.46 times more likely to develop ASD compared to those without such a history. 

How to Prevent Acute Stress Disorder (ASD)

To prevent Acute Stress Disorder (ASD), early psychological intervention is compulsory. Immediate access to mental health support following a traumatic event significantly reduces the risk of developing ASD. Early intervention, initiated within the first 24 hours post-trauma, is highly effective in preventing the onset of Acute Stress Disorder (ASD). A study by Rothbaum BO et al. 2012, titled “Early Intervention May Prevent the Development of Post-traumatic Stress Disorder: A Randomized Pilot Civilian Study with Modified Prolonged Exposure” suggests that participants who received treatment within 24 hours experienced a statistically significant decrease in stress-related symptoms over time. For instance, after 4 weeks, the intervention group had a 22% reduction in stress scores compared to the control group (mean decrease from 24.54 to 19.09), and this improvement continued through the 12-week follow-up.

Other prevention techniques include psychoeducation for individuals and communities about trauma responses, teaching coping strategies, and creating supportive environments. Engaging in mindfulness practices and establishing social support systems also help mitigate the impact of trauma and reduce the likelihood of ASD onset.

What Comorbid Conditions are Common with Acute Stress Disorder (ASD)? 

The comorbid conditions common with Acute Stress Disorder (ASD) include Post-Traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Panic Disorder, Substance Use Disorders, Adjustment Disorders, Dissociative Disorders, and Obsessive-Compulsive Disorder (OCD). These conditions co-occur with ASD due to overlapping symptoms and shared stress-related triggers. For instance, ASD progresses into PTSD, and symptoms of depression and anxiety exacerbate distress, complicating recovery and overall mental health.

The comorbid conditions common with Acute Stress Disorder (ASD) are as follows:

• Post-Traumatic Stress Disorder (PTSD): PTSD is a condition where trauma-related symptoms persist for more than a month after exposure to a traumatic event. PTSD develops following untreated ASD, with symptoms that include flashbacks, avoidance and heightened arousal. Approximately 3.5% of U.S. adults experience PTSD annually, with a lifetime prevalence of around 9% in the general population, according to a study by the American Psychiatric Association titled “What is Posttraumatic Stress Disorder (PTSD)?” Among adolescents ages 13-18, the lifetime prevalence is higher, at about 8%. Women are particularly vulnerable, being twice as likely as men to develop PTSD at some point in their lives.
• Major Depressive Disorder (MDD): Major Depressive Disorder (MDD) is characterized by persistent sadness, loss of interest, and fatigue. MDD frequently coexists with ASD, as trauma leads to severe mood disturbances and hopelessness. As of 2021, around 8.3% of U.S. adults experienced a major depressive episode, and the condition is even more prevalent among youth, affecting approximately 15% of individuals ages 12-17, according to a study by the National Institute of Mental Health titled “Major Depression.” Across a lifetime, nearly 21% of adults are expected to develop MDD, making it one of the most common mental health disorders in the country. 
• Generalized Anxiety Disorder (GAD): Generalized Anxiety Disorder (GAD) is marked by chronic, excessive worry and tension. GAD overlaps with Acute Stress Disorder, as both involve heightened anxiety, but GAD is a long-term condition triggered by both trauma and other stressors. In the United States, Generalized Anxiety Disorder (GAD) affects approximately 5.7% of adults over their lifetime, according to a study by the National Institute of Mental Health titled “Generalized Anxiety Disorder.” The prevalence differs significantly by gender, with about 3.4% of females affected compared to 1.9% of males. GAD commonly presents in early adulthood, with a median age of onset around 30 years. 
• Panic Disorder: Panic disorder involves recurrent panic attacks and intense fear, co-occurring with Acute Stress Disorder due to trauma-related fears and hypervigilance, which trigger panic episodes. In the United States, approximately 4.7% of adults experience panic disorder at some point in their lives, according to a study by the National Institute of Mental Health titled “Panic Disorder.” This condition tends to affect women twice as often as men.  
• Substance Use Disorders: Substance abuse develops as a coping mechanism to alleviate ASD symptoms, leading to dependency and further psychological distress. In 2021, approximately 48.7 million people aged 12 or older in the United States, or 17.3% of the population in that age group, experienced a substance use disorder (SUD), according to a study by the Substance Abuse and Mental Health Services Administration (SAMHSA) titled “HHS, SAMHSA Release 2022 National Survey on Drug Use and Health Data.” This includes a breakdown of 29.5 million people with an alcohol use disorder (AUD), 27.2 million people with a drug use disorder (DUD), and 8.0 million people who experienced both AUD and DUD.
• Adjustment Disorders: Adjustment disorders involve difficulties adjusting to a stressful life change and are common with ASD when individuals struggle to cope with trauma, affecting daily functioning. About 5–20% of outpatient mental health visits are primarily for adjustment disorders, while in primary care, 11–18% of patients attending these settings are affected by adjustment disorders, according to a study by Medscape titled “Adjustment Disorder.”
• Dissociative Disorders: Dissociative disorders involve disruptions in memory, identity, or perception of reality. Dissociative symptoms are common in Acute Stress Disorder, as individuals detach mentally from traumatic experiences as a coping response. Dissociative disorders are relatively rare in the United States, affecting approximately 2% of the general population, according to a book by Hawayek, J et al. 2023. Titled “Epidemiology of Dissociative Identity Disorder.”
• Obsessive-Compulsive Disorder (OCD): Obsessive-compulsive Disorder (OCD) is a disorder marked by unwanted, repetitive thoughts and behaviors. OCD coexists with ASD when trauma triggers obsessive concerns and compulsive actions as coping mechanisms. Obsessive-Compulsive Disorder (OCD) affects around 2.3% of adults in the U.S. during their lifetime, with many experiencing symptoms beginning in childhood or adolescence, according to a study by the National Institute of Mental Health titled “Panic Disorder.” Among children and teens, approximately 1 in 100 are affected by OCD.

What is the Difference Between Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD)?

The main difference between Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) is the duration and onset of symptoms following a traumatic event. ASD symptoms appear within three days to one month after trauma exposure and include intense fear, dissociation, and re-experiencing the trauma. If these symptoms persist beyond a month, the diagnosis shifts to PTSD, which is marked by a longer-lasting and more complex symptomatology, including heightened anxiety and avoidance of trauma reminders.

ASD is seen as an early response to trauma and resolves with treatment, whereas PTSD requires extended therapy. According to a study by Kornør H et al. 2008, titled “Early trauma-focused cognitive-behavioral therapy to prevent chronic post-traumatic stress disorder and related symptoms: a systematic review and meta-analysis” trauma-focused cognitive-behavioral therapy (TF-CBT) reduced PTSD diagnosis significantly; after 3–6 months post-treatment, only 32% of TF-CBT-treated participants met the criteria for PTSD, compared to 58% in the supportive counseling group, showing that early intervention for ASD mitigate the progression to chronic PTSD.

What is the Difference Between Acute Stress Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD)?

The main difference between Acute Stress Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) is that ASD is a trauma-related condition that develops within days of a traumatic event, whereas ADHD is a neurodevelopmental disorder that begins in childhood and is characterized by persistent inattention, hyperactivity, and impulsivity. ASD is temporary, with symptoms that resolve within a month of treatment, while ADHD is a chronic condition that persists over time and significantly impacts functioning across various life domains.

ASD symptoms are largely related to trauma response, including re-experiencing the traumatic event, hypervigilance, and dissociation. In contrast, ADHD symptoms such as difficulty maintaining attention, forgetfulness, and impulsivity are not related to trauma but rather to deficits in executive functioning. While ASD symptoms improve with trauma-focused CBT, ADHD requires long-term management strategies, including behavioral therapy and sometimes medication.

What is the Difference Between Acute Stress Disorder (ASD) and Adjustment Disorder (AD)?

The main difference between Acute Stress Disorder (ASD) and Adjustment Disorder (AD) is that ASD occurs in response to a traumatic event and includes specific trauma-related symptoms like intrusive memories and dissociation, whereas Adjustment Disorder happens in reaction to a significant life change or stressor (e.g., job loss) and primarily involves emotional and behavioral symptoms such as anxiety, depression, and social withdrawal. ASD has a shorter onset, within 3 days to 1-month post-trauma, while AD symptoms arise within 3 months of the stressor and last longer if untreated, as studied by the American Psychiatric Association in “Acute and Posttraumatic Stress Disorders (ASD and PTSD) in Children and Adolescents.”

Acute Stress Disorder (ASD) includes heightened arousal and flashbacks, closely resembling PTSD if symptoms persist, while AD does not include flashbacks but presents with depressed mood or anxiety based on the type of adjustment disorder diagnosed. The Outcome of Depression International Network (ODIN) project shows adjustment disorder in less than 1% of the population, while 1.3 to 11.2 percent of the population develop acute stress disorder (ASD), as studied by Fanai M, Khan MAB. et al. 2023, titled “Acute Stress Disorder.”

What is the Difference Between Acute Stress Disorder (ASD) and Brief Psychotic Disorder (BPD)?

The main difference between Acute Stress Disorder (ASD) and Brief Psychotic Disorder (BPD) is that ASD is a response to trauma with symptoms primarily related to anxiety and dissociation, while BPD involves sudden, temporary psychotic symptoms like delusions, hallucinations, and disorganized speech without necessarily involving trauma. ASD symptoms last between 3 days to a month post-trauma, while BPD episodes also last less than a month but occur without a specific external cause and are marked by a clear psychotic break from reality.

While both ASD and BPD are time-limited, the symptoms of BPD align more with disorders like schizophrenia and resolve on their own or with antipsychotic treatment, whereas ASD symptoms resolve with trauma-focused CBT and do not include psychotic features. BPD has a lower prevalence, ranging from 0.05% to 2% over a person’s lifetime, according to a study by Stephen A, Lui F., et al. 2023, titled “Brief Psychotic Disorder.” 

Which Celebrities Have Experienced Acute Stress Disorder?

Celebrities who have experienced Acute Stress Disorder include Ariana Grande, Tracy Morgan, and Whoopi Goldberg, who have each shared their struggles following traumatic incidents. These high-profile cases highlight the emotional and psychological impacts of extreme stress and serve to increase awareness around conditions like Acute Stress Disorder (ASD).

The celebrities who have experienced Acute Stress Disorder are as follows:

• Ariana Grande – Following a traumatic incident at her concert in Manchester in 2017, Ariana Grande opened up about her symptoms, which resemble both ASD and PTSD. She has spoken about lingering trauma and anxiety related to flashbacks from the attack.
• Tracy Morgan – After surviving a severe car accident in 2014 that took the life of a friend, Tracy Morgan experienced symptoms associated with ASD and PTSD, such as survivor’s guilt and heightened anxiety when driving or riding in vehicles.
• Whoopi Goldberg – Whoopi Goldberg has spoken about her long-standing fear of flying, a reaction to witnessing a mid-air collision between two planes in 1978. Her symptoms include flashbacks and significant anxiety, which align with ASD and PTSD criteria.