Acute stress disorder risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Common risk factors in the development of acute stress disorder are preexisting psychiatric problems, loss of a loved one in the event, significant injury from the event, dissociation at the time of the traumatic event, development of serious depressive symptoms with 1 week that last for 1 month or longer, numbness, a sense of relieving the trauma, depersonalization, and motor restlessness after the event, witnessing of frightful images, previous trauma, extended exposure to danger, loss of home or community, toxic exposure, and absent social supports.

Risk Factors

Factors increasing the risk of acute stress disorder include the following:

• Preexisting psychiatric problems
• Loss of a loved one in the event
• Significant injury from the event
• Dissociation at the time of the traumatic event
• Development of serious depressive symptoms within 1 week that last for 1 month or longer
• Numbness, a sense of reliving the trauma, depersonalization, and motor restlessness after the event
• Witnessing of frightful images
• Previous trauma
• Extended exposure to danger
• Loss of home or community
• Toxic exposure
• Absent social supports

Risk and Prognostic Factors Temperamental Risk factors include prior mental disorder, high levels of negative affectivity (neuroticism), greater perceived severity of the traumatic event, and an avoidant coping style(Barton et al. 1996; Harvey and Bryant 1998b; Harvey and Bryant 1999b). Catastrophic appraisals of the traumatic experience, often characterized by exaggerated appraisals of future harm, guilt, or hopelessness, are strongly predictive of acute stress disorder(Smith and Bryant 2000; Warda and Bryant 1998).

Environmental First and foremost, an individual must be exposed to a traumatic event to be at risk for acute stress disorder. Risk factors for the disorder include a history of prior trauma(Barton et al. 1996; Harvey and Bryant 1998b; Harvey and Bryant 1999b).

Genetic and physiological Females are at greater risk for developing acute stress disorder(Barton et al. 1996; Harvey and Bryant 1998b; Harvey and Bryant 1999b).

Elevated reactivity, as reflected by acoustic startle response, prior to trauma exposure increases the risk for developing acute stress disorder(Guthrie and Bryant 2005).

It is probable that most risk factors for posttraumatic stress disorder (PTSD) also apply to ASD [7]. Consistent with this presumption is evidence that ASD is associated with the following characteristics [8-10]:

●History of a pre-trauma psychiatric disorder ●History of traumatic exposures prior to recent exposure ●Female gender ●Trauma severity ●Neuroticism ●Avoidant coping

Risk factors	Description
Temperamental	Prior mental disorder High levels of negative affectivity (neuroticism) Greater perceived severity of the traumatic event An avoidant coping style Catastrophic appraisals of the traumatic experience, often characterized by exaggerated assessment of future harm, guilt, or hopelessness, are strongly predictive of acute stress disorder
Environment	History of prior trauma Loss of a loved one in the event Significant injury from the event Witnessing of frightful images Extended exposure to danger Loss of home or community
Genetic and physiological	Females are at greater risk for developing acute stress disorder Elevated reactivity, as reflected by acoustic startle response, prior to trauma exposure increases the risk for developing acute stress disorder