Acute Stress Disorder 285
Genetic and physiological. Females are at greater risk for developing acute stress dis-
order.
Elevated reactivity, as reflected by acousti c startle response, prior to trauma exposure
increases the risk for developing acute stress disorder. 
Culture-Related Diagnostic Issues
The profile of symptoms of acute stress disorder may vary cross-culturally, particularly
with respect to dissociative symptoms, ni ghtmares, avoidance, and somatic symptoms
(e.g., dizziness, shortness of breath, heat se nsations). Cultural sy ndromes and idioms of
distress shape the local symptom profiles of acute stress disorder. Some cultural groups
may display variants of dissociative response s, such as possession or trancelike behaviors
in the initial month after trauma exposure. Pa nic symptoms may be salient in acute stress
disorder among Cambodians because of the as sociation of traumatic exposure with panic-
like khyâl  attacks, and ataque de nervios  among Latin Americans may also follow a traumatic
exposure. 
Gender-Related Diagnostic Issues
Acute stress disorder is more prevalent am ong females than among males. Sex-linked neu-
robiological differences in stre ss response may contribute to females’ increased risk for
acute stress disorder. The increased risk for the disorder in females may be attributable in
part to a greater likelihood of exposure to th e types of traumatic events with a high con-
ditional risk for acute stress  disorder, such as rape and other interpersonal violence. 
Functional Consequences of Acute Stress Disorder
Impaired functioning in social, interpersona l, or occupational domains has been shown
across survivors of accidents, assault, and rape  who develop acute stress disorder. The ex-
treme levels of anxiety that may be associa ted with acute stress disorder may interfere