Trauma- and stressor-related disorders
Acute Stress Disorder
Acute stress disorder can develop during the first days and weeks after exposure to death, serious injury or sexual violence, with a clinically significant combination of intrusive, dissociative, avoidant and arousal symptoms.
An early response to trauma
Short-lived stress reactions after trauma are common and do not automatically indicate a disorder. Acute stress disorder requires at least nine specified symptoms, significant distress or impairment, and a duration of three days to one month after the event.
Eligible exposure includes directly experiencing or witnessing the event, learning that violent or accidental death or serious harm affected someone close, or repeated extreme occupational exposure to distressing details. General media exposure does not usually meet this threshold unless it is work-related.
Signs and assessment
- Intrusive memories, nightmares, flashbacks or marked distress when reminded of the event.
- Emotional numbing, altered reality, gaps in memory, avoidance, poor sleep, irritability, hypervigilance or an exaggerated startle response.
- A professional also considers injury, traumatic brain injury, substances, medication, brief psychosis, depression and immediate safety.
Support and treatment
Early care prioritises physical and practical safety, basic needs, calm information, social support and planned follow-up. For adults with acute stress disorder or clinically important symptoms, individual trauma-focused CBT may be offered by a trained professional. Support for children and adolescents is developmentally adapted and may involve caregivers.
People should not be pressured into a single detailed retelling of the event as a universal debriefing. Pain, sleep, substance use, depression and suicide risk are addressed alongside trauma symptoms.
When to seek help
Seek prompt help when symptoms prevent sleep, work, caregiving or basic daily functioning, or when there is increasing substance use, self-harm or a continuing threat. Ongoing violence, serious injury, severe confusion, inability to care safely for oneself or current suicidal intent needs emergency medical and protective support.