Abstract
Acute stress disorder (ASD) is a new DSM-IV diagnostic category, characterized by dissociative, intrusive, avoidance, and hyperarousal symptoms in the first month after a traumatic experience. The goal of the present study was to examine the utility of this diagnosis. In a prospective study, 79 mixed trauma victims who met DSM-IV symptom criteria for PTSD within 1 month following a traumatic event were followed through three months post-event. Dissociative symptoms in ASD only partially captured distress and dysfunction during the first month. Participants with and without ASD showed similar patterns of recovery, with only small differences that disappeared at three months post-event. Interestingly, initial PTSD avoidance but not ASD dissociative symptoms predicted PTSD severity at 3 months.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Psychiatric Association. (1994a). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
American Psychiatric Association. (1994b). Diagnostic and statistical manual of mental disorders (4th edn. Rev. Sourcebook). Washington, DC: Author.
Barton, K. A., Blanchard, E., & Hickling, E. J. (1996). Antecedents and consequences of acute stress disorder among motor vehicle accident victims. Behaviour Research and Therapy, 34, 805–813.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.
Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous and Mental Disease, 174, 727–735.
Bremner, J. D., Southwick, S., Brett, E., Fontana, A., Rosenheck, R., & Charney, D. S. (1992). Dissociation and posttraumatic stress disorder in Vietnam combat veterans. American Journal of Psychiatry, 149, 328–332.
Brewin, C. R., Andrews, B., Rose, S., & Kirk, M. (1999). Acute stress disorder and posttraumatic stress disorder in victims of violent crime. American Journal of Psychiatry, 156, 360–366.
Bryant, R. A., & Harvey, A. G. (1997). Acute stress disorder: A critical review of diagnostic issues. Clinical Psychology Review, 17, 757–773.
Bryant, R. A., & Harvey, A. G. (1998). Relationship between acute stress disorder and posttraumatic stress disorder following mild traumatic brain injury. American Journal of Psychiatry, 155, 625–629.
Cardeña, E., Classen, K., & Spiegel, D. (1991). Stanford Acute Stress Reaction Questionnaire. Stanford, CA: Stanford University Medical School.
Carlson, E. B., & Putnam, F. W. (1993). An update on the Dissociative Experiences Scale. Dissociation: Progress in the Dissociative Disorders, 6, 16–27.
Classen, C., Koopman, C., Hales, R., & Spiegel, D. (1998). Acute stress disorder as a predictor of posttraumatic stress symptoms. American Journal of Psychiatry, 155, 620–624.
Epstein, R. S., Fullerton, C. S., & Ursano, R. J. (1998). Posttraumatic stress disorder following an air disaster: A prospective study. American Journal of Psychiatry, 155, 934–938.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders—Patient edition (SCID-I/P, version 2). New York: New York State Psychiatric Institute, Biometrics Research Department.
Foa, E. B., Riggs, D., Dancu, C. V., & Rothbaum, B. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459–473.
Foa, E. B., & Rothbaum, P. O. (1998). Treating the trauma of rape. New York: Guilford Press.
Foa, E. B., Rothbaum, B. O., Riggs, D. S., & Murdock, T. B. (1991). Treatment of posttraumatic stress disorder in rape victims: A comparison between cognitive–behavioral procedures and counseling. Journal of Consulting and Clinical Psychology, 59, 715–723.
Harvey, A. G., & Bryant, R. A. (1998). The relationship between acute stress disorder and posttraumatic stress disorder: A prospective evaluation of motor vehicle accident survivors. Journal of Consulting and Clinical Psychology, 66, 507–512.
Harvey, A. G., & Bryant, R. A. (1999). The relationship between acute stress disorder and posttraumatic stress disorder: A two-year prospective evaluation. Journal of Consulting and Clinical Psychology, 67, 985–988.
Koopman, C., Classen, C., & Spiegel, D. A. (1994). Predictors of posttraumatic stress symptoms among survivors of the Oakland/ Berkeley, Calif., firestorm. American Journal of Psychiatry, 151, 888–894.
Koren, D., Arnon, I., & Klein, E. (1999). Acute stress response and posttraumatic stress disorder in traffic accident victims: A one-year prospective, follow-up study. American Journal of Psychiatry, 156, 367–373.
Marmar, C. R., Weiss, D. S., & Metzler, T. J. (1997). The Peritraumatic Dissociative Experiences Questionnaire. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD. (pp. 412–428). New York: Guilford Press.
Marmar, C. R., Weiss, D. S., Schlenger, W. E., Fairbank, J. A., Jordan, B. K., Kulka, R. A., et al. (1994). Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans. American Journal of Psychiatry, 151, 902–907.
Marshall, R. D., Spitzer, R., & Liebowitz, M. R. (1999). Review and critique of the new DSM-IV diagnosis of acute stress disorder. American Journal of Psychiatry, 156, 1677–1685.
Paykel, E. S., Weissman, M., Prusoff, B. A., & Tonks, C. M. (1971). Dimensions of social adjustment in depressed women. Journal of Nervous and Mental Disease, 152, 158–172.
Rothbaum, B. O., Foa, E. B., Riggs, D. S., Murdock, T., & Walsh, W. (1992). A prospective examination of post-traumatic stress disorder in rape victims. Journal of Traumatic Stress, 5, 455–475.
Shalev, A. Y., Freedman, S., & Peri, T. (1998). Prospective study of posttraumatic stress disorder and depression following trauma. American Journal of Psychiatry, 155, 630–637.
Spiegel, D., Koopman, C., Cardeña, E., & Classen, C. (1996). Dissociative symptoms in the diagnosis of acute stress disorder. In L. K. Michelson & W. J. Rav (Eds.), Handbook of dissociation (pp. 367–380). New York: Plenum.
Staab, J. P., Grieger, T. A., Fullerton, C. S., & Ursano, R. J. (1996). Acute stress disorder, subsequent posttraumatic stress disorder and depression after a series of typhoons. Anxiety, 2, 219–225.
Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariate statistics (3rd edn.). New York: HarperCollins.
Tichenor, V., Marmar, C. R., Weiss, D. S., Metzler, T. J., & Ronfeldt, H. (1996). The relationship of peritraumatic dissociation and posttraumatic stress: Findings in female Vietnam theater veterans. Journal of Consulting and Clinical Psychology, 64, 1054–1059.
Weissman, M., & Paykel, E. S. (1974). The depressed woman: A study of social relations. Chicago: University of Chicago Press.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Zoellner, L.A., Jaycox, L.H., Watlington, C.G. et al. Are the Dissociative Criteria in ASD Useful?. J Trauma Stress 16, 341–350 (2003). https://doi.org/10.1023/A:1024461801508
Issue Date:
DOI: https://doi.org/10.1023/A:1024461801508