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Acute stress disorder: a synthesis and critique
Allison G Harvey1, Richard A Bryant
1Department of Experimental Psychology, University of Oxford, United Kingdom. allison.harvey@psy.ox.ac.uk
Psychological Bulletin
|October 31, 2002
Summary
The acute stress disorder (ASD) diagnosis lacks strong justification, questioning its clinical utility for predicting chronic posttraumatic stress disorder (PTSD). Alternative approaches are needed to identify individuals at risk after trauma.
Area of Science:
- Psychiatry and Psychology
- Trauma Studies
- Mental Health Diagnostics
Background:
- Acute Stress Disorder (ASD) was established to identify initial trauma reactions.
- ASD aims to predict the development of chronic Posttraumatic Stress Disorder (PTSD).
- Concerns exist regarding the conceptual and empirical basis of the ASD diagnosis.
Purpose of the Study:
- To critically review the rationale for the ASD diagnosis.
- To examine conceptual and empirical issues associated with ASD.
- To explore alternative frameworks for understanding acute trauma responses.
Main Methods:
- Literature review and critical analysis of existing research on ASD.
- Discussion of evidence for and against peritraumatic dissociation in acute trauma.
- Review of biological and cognitive mechanisms mediating acute trauma response.
Main Results:
- The current ASD diagnosis has limited justification in its present form.
- Evidence regarding the role of peritraumatic dissociation in predicting PTSD is debated.
- Biological and cognitive factors influencing acute trauma responses require further investigation.
Conclusions:
- The existing ASD diagnosis is not well-supported by current evidence.
- Rethinking the conceptualization of acute trauma reactions is necessary.
- New methods are needed to identify individuals at risk for developing PTSD post-trauma.