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Are the dissociative criteria in ASD useful?
Lori A Zoellner1, Lisa H Jaycox, Christina G Watlington
1Center for the Treatment and Study of Anxiety, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. zoellner@u.washington.edu
Journal of Traumatic Stress
|August 5, 2003
Summary
Acute stress disorder (ASD) diagnosis may not fully capture trauma recovery. Initial PTSD avoidance symptoms, not ASD dissociative symptoms, predicted later PTSD severity in trauma victims.
Area of Science:
- Psychiatry
- Trauma Studies
- Mental Health Diagnostics
Background:
- Acute stress disorder (ASD) is a DSM-IV diagnosis for symptoms within one month of trauma.
- ASD includes dissociative, intrusive, avoidance, and hyperarousal symptoms.
- The diagnostic utility of ASD requires further examination.
Purpose of the Study:
- To evaluate the clinical utility of the Acute Stress Disorder (ASD) diagnosis.
- To assess the predictive value of ASD symptoms on long-term trauma recovery.
- To compare recovery patterns in trauma victims with and without ASD.
Main Methods:
- Prospective study design.
- Inclusion of 79 mixed trauma victims meeting DSM-IV PTSD criteria within one month post-trauma.
- Follow-up assessment at three months post-event.
Main Results:
- Dissociative symptoms of ASD partially reflected distress and dysfunction in the first month.
- No significant differences in recovery patterns were observed between participants with and without ASD at three months.
- Initial post-traumatic stress disorder (PTSD) avoidance symptoms, not ASD dissociative symptoms, predicted PTSD severity at three months.
Conclusions:
- The diagnostic utility of Acute Stress Disorder (ASD) in predicting long-term outcomes appears limited.
- Initial PTSD avoidance symptoms may be a more significant predictor of later PTSD severity than ASD-specific dissociative symptoms.
- Further research is needed to refine diagnostic criteria and understand trauma recovery trajectories.