Acute Stress Disorder Basics

Acute stress disorder occurs when a child has a particularly strong reaction to a stressing event such as a death or illness in the family, a serious injury, natural disaster, or other intensely stressful experience. This reaction, which happens from three days to a month after the event, goes beyond the normal upset you'd expect. It may result not only in difficulties coping with the event, but in impaired ability to function at home, at school and in social settings. Acute Stress Disorder is a less severe and long-lasting condition than the better-known post-traumatic stress disorder (PTSD).

Acute Stress Disorder: What Is It?

It’s perfectly normal for a child to be upset by a distressing event, such as a natural disaster or an act of violence, a severe accident, a medical emergency, or the suicide of a family member. However, if a child experiences a particularly strong reaction to a disturbing event, it may result not only in difficulties coping with the event, but in impaired ability to function at home, at school and in social settings. When this happens from 3 days to a month after the event, it’s possibly the result of acute stress disorder.

If the symptoms don’t subside after a month, a child may progress to the more impairing and long-term post-traumatic stress disorder (PTSD).

Acute Stress Disorder: What to Look For

The signs that a child who’s experienced a distressing event may have developed acute stress disorder include a foggy, dazed, detached demeanor, and intrusive thoughts of the event that may be acted out in intense, repetitive play—for instance, a child who’s been in a car accident may repeatedly crash toy cars together. A child who doesn’t have intrusive memories of the traumatic event might still experience distress when exposed to situations that resemble aspects of it, like wind for one who’s been through a hurricane. She might also strenuously avoid reminders of the event, by refusing to talk about it, minimizing emotions related to it—through alcohol use, for a teenager—or refusing to go back to the setting where it occurred, or interact with other people who experienced it. She may also have nightmares associated with the event, and have difficulty sleeping and concentrating.

Acute Stress Disorder: Risk Factors

There are several risk factors that might make a child who has been exposed to a traumatic event more likely to develop acute stress disorder. Children who have previously been exposed to trauma will be more at risk, as will those with a prior mental disorder. Children who appear deeply affected by the traumatic event, with strong feelings of guilt or hopelessness, or an amplified fear of future harm, are more likely to develop the disorder. Kids with more negative temperaments and avoidant coping styles are also at risk. Girls are more likely to develop acute stress disorder.

Acute Stress Disorder: Diagnosis

For your child to be diagnosed with acute stress disorder, he must have been exposed to a traumatic event, including real or threatened death, serious injury, or sexual violation. He might have experienced the distressing event himself, witnessed it, or learned about it happening to a close family member.

To be diagnosed with this disorder, a child must exhibit a range of these symptoms: recurring, intrusive memories or dreams of the event; dissociative states in which he feels it is recurring; distress triggered by things that remind him of the event; and efforts to avoid distressing memories, thoughts or feelings, and situations that remind him of the event. Other symptoms include irritability, difficulty sleeping, hypervigilance, problems with concentration, and negative mood.

Acute stress disorder is diagnosed only if the symptoms persist from 3 to 30 days after the event.

Acute Stress Disorder: Treatment

Some cases of acute stress disorder resolve themselves, but other cases can progress into the more severe PTSD. Cognitive behavior therapy has been shown to to be effective kids with acute stress disorder.

Acute Stress Disorder: Risk For Other Disorders

Although they are distinct disorders, acute stress disorder exists on a “sliding scale” with the more serious PTSD.