The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors
Open accessAbstract
This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.
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Acute stress disorder is associated with PTSD.
“although acute stress disorder (ASD), a disorder characterized by dissociative symptoms during or immediately following a traumatic event, is associated with PTSD (e.g., Creamer, O'Donnell, & Pattison, 2004; Harvey & Bryant, 2000; Murray et al., 2002)”
From Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis (2012) · cites this paper as Creamer, O'Donnell, & Pattison, 2004
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“A few prospective empirical studies have addressed the predictive validity of the ASD diagnosis (e.g., Brewin, Andrews, Rose, & Kirk, 1999; Harvey & Bryant, 1999; Harvey & Bryant, 2000).”
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The capacity of acute stress disorder to predict posttraumatic psychiatric disorders
Bryant, R. A., Creamer, M., O’Donnell, M., Silove, D., & McFarlane, A. C. (2012) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2011.10.007 · Cited by 88 · see citing works
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- Authors
- Creamer, M., O’Donnell, M. L., & Pattison, P.
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- Creamer, Mark
- ORCID
- Creamer, Mark
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2004-03
- Volume
- 42
- Issue
- 3
- Pages
- 315-328
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W1969895707
- Cited by
- 105
- References
- 4
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 4 · 2021: 6 · 2020: 3 · 2019: 5 · 2018: 2 · 2017: 6 · 2016: 3 · 2015: 2 · 2014: 2 · 2013: 2 · 2012: 7
- FWCI
- 6.20
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- acute stress disorder, post-traumatic stress disorder, trauma survivors, severe injuries, dissociative symptoms, re-experiencing, arousal, PTSD screening, diagnostic sensitivity, early intervention
- MeSH terms
- Adolescent, Adult, Aged, Dissociative Disorders, Female, Humans, Male, Middle Aged, Prospective Studies, Regression Analysis, Stress Disorders, Post-Traumatic, Wounds and Injuries, Survivors, Stress Disorders, Traumatic, Acute
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