Stress Disorders

Stress disorders result as an exposure to a traumatic or stressful event. A traumatic event can cause significant physical, emotional, or psychological harm. Two such disorders are acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). Both share many of the same symptoms and can include depression, irritability, intrusive thoughts, aggression, severe anxiety and dissociation.

ASD typically occurs right after the traumatic event and lasts three days to one month. PTSD is a chronic condition which may appear sometime after the traumatic event and the duration is over a month.

According to the American Psychiatric Association, approximately 50% of individuals who develop PTSD initially presented with ASD. Common treatments include cognitive behavioral therapy (CBT); mindfulness training, medication and/or eye movement desensitization and reprocessing treatment (EMDR).

Screening Tools

PCPs may use the five-item Primary Care PTSD Screen (PCPS) or the 20-item self-report questionnaire, PTSD Checklist for DSM-5 (PCL-5).

Clinical Guidelines and Best Practices

Post-Traumatic Stress Disorder and Acute Stress Disorder Clinical Practice Guideline (PDF)

The American Psychiatric Association (APA) Clinical Practice Guideline for the Assessment and Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder, and Quick Reference Guide (2004); and the APA Guideline Watch: Practice Guideline for the Treatment of Patients with Acute Stress Disorder and Posttraumatic Stress Disorder (2009).

The Department of Veterans Affairs / Department of Defense Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder (2017) (PDF)

The American Psychological Association (APA) Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults (2017)

Patient Resources

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Common Signs and Symptoms

Intrusion symptoms associated with traumatic event(s)
Persistent avoidance of stimuli associated with the traumatic event(s)
Marked alterations in arousal and reactivity associated with the traumatic event(s)
Negative alterations in cognitions and mood associated with the traumatic event(s)
Dissociative symptoms including persistent or recurrent symptoms of depersonalization or de-realization

Behavioral Health Conditions