Acute stress disorder is defined as an acute stress reaction that occurs in the first 4 weeks after a person has been exposed to a traumatic event (threatened death, serious injury e.g. road traffic accident, sexual assault etc). This is in contrast to post-traumatic stress disorder (PTSD) which is diagnosed after 4 weeks.

Features include:

• intrusive thoughts e.g. flashbacks, nightmares
• dissociation e.g. 'being in a daze', time slowing
• negative mood
• avoidance
• arousal e.g. hypervigilance, sleep disturbance

Management

• trauma-focused cognitive-behavioural therapy (CBT) is usually used first-line
• benzodiazepines
  • sometimes used for acute symptoms e.g. agitation, sleep disturbance
  • should only be used with caution due to addictive potential and concerns that they may be detrimental to adaptation