Acute Stress Disorder (ASD) is a trauma-related mental health condition that can develop in the first month after a traumatic event. It can affect thoughts, emotions, physical arousal, and behavior.
Unlike stress that is caused by daily events, ASD may develop after exposure to or experiencing traumatic events like serious injury, sexual violence, or witnessing death or serious injury. must last at least 3 days and occur within 1 month after trauma exposure, and if symptoms continue even after a month, clinicians evaluate for PTSD.
In this read, we explained what acute stress disorder is, how common it is after trauma, DSM-5-TR symptoms and criteria, and how it differs from PTSD. Moreover, we will explain how clinicians diagnose, along with treatment options, and you should seek clinical assistance.
Early Trauma Symptoms Within a Month?
Get a focused evaluation for ASD and a plan for symptom relief and follow-up care. CPG offers outpatient trauma-informed care with in-person and telehealth visits.
How Common Is Acute Stress Disorder After Trauma?
It varies by trauma type and by how ASD is measured, but ASD is not rare in the first month after a traumatic event. Studies report that within one month of a trauma, 6% to 33% of survivors are diagnosed with ASD. The percentage is lower after some accidents/disasters and higher after violence-related events.
A large systematic review and meta-analysis compared ASD across different trauma types and reported:
- 14.1% after war-related trauma
- 36.0% after interpersonal trauma
- 15.9% after accident-related trauma
- 21.9% after disaster-related trauma
Acute Stress Disorder Symptoms
ASD symptoms are divided into five groups in DSM-5-TR summaries: intrusion, negative mood, dissociation, avoidance, and arousal.
Intrusion Symptoms
- Recurrent and involuntary distress tied to traumatic memories
- Nightmares or distressing dreams related to trauma
- Flashbacks
- Strong psychological or physical distress when reminded of traumatic events
Negative Mood
- Persistent inability to experience positive emotions (for example, happiness, satisfaction, or loving feelings)
Dissociative Symptoms
- Altered sense of reality (feeling in a daze, time slowing, detachment)
- Inability to remember an important part of the traumatic event (dissociative amnesia)
Avoidance Symptoms
- Efforts to avoid distressing memories, thoughts, or feelings related to the trauma
- Efforts to avoid people, places, conversations, activities, objects, and situations related to a traumatic event
Arousal Symptoms
- Sleep disturbance
- Irritability or angry outbursts
- Hypervigilance
- Difficulty concentrating
- Exaggerated startle response
Flashbacks, Nightmares, or Hypervigilance?
Trauma symptoms can disrupt sleep, focus, and daily function. Talk to a clinician about ASD treatment options. At CPG, care is matched to the symptom pattern and the 3-day to 1-month ASD window.
Acute Stress Disorder DSM-5 Criteria
DSM-5-TR diagnostic summaries specify:
Trauma Exposure (Criterion A)
This includes
- Direct exposure
- Witnessing in person
- Learning that a close family member/friend experienced a violent or accidental traumatic event
- Repeated/extreme exposure to aversive details (typically occupational exposure, such as first responders).
Symptoms Threshold (Criterion B)
ASD requires at least 9 symptoms out of 14 from the five groups listed above. ASD applies only in the 3-day to 1-month window after trauma; beyond that, clinicians assess for PTSD, and ASD no longer applies.
Acute Stress Disorder vs PTSD
The clearest difference is duration:
- Acute Stress Disorder is diagnosed within 3 days to 1 month after trauma
- PTSD is assessed when traumatic symptoms persist beyond 1 month
PTSD diagnosis requires meeting symptom counts across specific clusters, while ASD is diagnosed based on the total number of symptoms (9 of 14) rather than cluster-by-cluster minimums.
Symptoms Lasting Past 2 Weeks?
If distress is persistent or worsening, early care can reduce symptom intensity and support recovery. CPG uses structured follow-up to monitor progress and adjust the plan as symptoms change.
Acute Stress Disorder Causes and Risk Factors
ASD is triggered by trauma exposure, but not everyone exposed to trauma develops ASD. The risk factors that increase the likelihood after trauma, including
- Prior trauma exposure
- Prior PTSD
- Prior mental health problems
- Dissociative-type reactions when confronted with trauma.
Population studies and trauma-sample studies also repeatedly highlight trauma severity with
- Assault
- Interpersonal violence exposure
- Post-event stressors (for example, ongoing safety concerns, legal/financial strain, disruption of housing or work)
How Clinicians Evaluate & Diagnose Acute Stress Disorder
DSM-5-TR criteria require the symptom threshold within the 3-day to 1-month window, with clinically significant distress or impairment and symptoms not better explained by substances or another medical condition.
A solid ASD evaluation typically covers:
- Trauma exposure type and timeline
- Symptoms across the five groups
- Functional impact (sleep, work/school performance, relationships, self-care)
- Dissociative symptoms (derealization, depersonalization, amnesia)
- Safety screening (self-harm risk, severe impairment, escalating agitation)
- Differential considerations (TBI, substance effects, medical contributors)
Acute Stress Disorder Treatment
ASD treatment focuses on symptom stabilization and a treatment plan that reduces the risk of long-term persistence.
Trauma-focused Psychotherapy
Trauma-focused cognitive behavioral therapy (TF-CBT) is widely described as a first-line treatment option for ASD.
Early Supportive Care
Early interventions also focus on sleep restoration, reducing avoidance expansion, and restoring daily structure. In the acute window (1st month), treatment often prioritizes practical coping skills, psychoeducation about trauma responses, and planned follow-up rather than open-ended supportive sessions alone.Trauma-focused cognitive behavioral therapy (TF-CBT) is widely described as a first-line treatment option for ASD
Medication
Medication may be considered for severe insomnia, severe anxiety, or agitation when clinically appropriate, but it is not the core treatment for ASD. Symptom-targeted prescribing requires careful reassessment as the acute window progresses.
Need Therapy and Medication Support?
Get outpatient trauma-focused care, including therapy options and medication management when appropriate. At CPG, treatment may include trauma-focused therapy and symptom-targeted medication support with monitoring.
When To Seek Care
Consider an evaluation when symptoms persist, intensify, or interfere with sleep, daily responsibilities, or relationships, especially after:
- car accidents or serious injuries
- assault, robbery, or sexual violence
- medical trauma (emergency events, ICU stays, sudden diagnoses)
- disasters and community violence
If there is immediate danger or risk of self-harm, emergency care is the right step. In the U.S., you can call or text 988 for the Suicide & Crisis Lifeline.
Why Choose Us
Capital Psychiatry Group provides outpatient care for trauma-related stress conditions with a structured approach in the early post-event window. Our clinicians focus on clear DSM-5-TR–aligned evaluation, symptom tracking across follow-up visits, and treatment planning that matches how symptoms present in real time.
Here are the benefits you can get from us:
- All insurance accepted
- Multi-state clinical presence
- No wait time in appointments
- HIPAA-compliant telepsychiatry
- Appointment within 24 hours
- Walk-in appointments
- Weekend appointments
- Trauma-focused cognitive behavioral therapy (TF-CBT)
- Therapy & counseling services
- Safe medication management
- Certified psychiatrists & psychologists
- Personalized treatment plans
- Patient-first approach
Final Words
After a traumatic event, intense symptoms in the first few weeks are common, but they should not be ignored when they disrupt sleep, the ability to experience positive emotions, daily function, or avoidance. If your symptoms are persisting or escalating, schedule an evaluation at CPG. Our mental health professionals can clarify what’s happening and guide the next steps with a focused plan including TF-CBT therapy, counseling, and medication.
Dissociation or Feeling “Unreal” After Trauma?
Derealization, depersonalization, and emotional numbness are treatable trauma responses; support is available. CPG evaluates dissociative symptoms carefully and builds a plan that prioritizes stabilization and sleep.
How we reviewed this article:
CPG experts follow strict sourcing standards, using peer-reviewed research, academic institutions, and trusted medical journals. Only reliable, evidence-based sources are cited to maintain accuracy and integrity.
- • https://www.ptsd.va.gov/understand/related/acute_stress.asp
- • https://trauma.criusmm.net/en/scientific-papers/systematic-review-and-meta-analysis-on-acute-stress-disorder-rates-following-different-types-of-traumatic-events/
- • https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/
- • https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM5_Severity-of-Acute-Stress-Symptoms-Adult.pdf
- • https://icmglt.org/acute-stress-disorder-structured-interview-asdi/
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