![]() To our knowledge, no published research has systematically examined the relationship between acute stress disorder and PTSD symptoms, despite the assumption stated in DSM-IV that acute stress disorder can lead to PTSD. These studies were conducted before the final definition of acute stress disorder and its inclusion in DSM-IV and, therefore, did not include a systematic assessment of all acute stress disorder symptoms and their relationship with later PTSD symptoms. The scientific basis for the diagnostic category of acute stress disorder was also justified by research showing that dissociative reactions immediately after a traumatic experience predicted later posttraumatic stress disorder (PTSD) symptoms ( 2– 4, 7, 11– 14). The specific diagnostic criteria for acute stress disorder were based on empirical evidence from studies that systematically documented acute stress reactions in response to traumatic events ( 2– 4, 7). Since Lindemann's observations there have been numerous studies that have reports of dissociative, avoidance, and hyperarousal symptoms shortly after traumatic experiences ( 2– 10). This diagnosis is based on a large body of research dating back to Lindemann's classic paper ( 1) in which he described survivors' immediate reactions to the Coconut Grove fire. Also, the reaction must not be due to the ingestion of substances or to a general medical condition or be attributable to a brief psychotic disorder or a preexisting axis I or axis II disorder. ![]() In addition, the symptoms must cause clinically significant difficulties in functioning and persist 2–28 days. To be diagnosed as suffering from acute stress disorder the individual must exhibit at least three dissociative symptoms along with at least one intrusion, avoidance, and hyperarousal symptom. CONCLUSIONS: These results suggest not only that being a bystander to violence is highly stressful in the short run, but that acute stress reactions to such an event further predict later posttraumatic stress symptoms.Īcute stress disorder is a new psychiatric diagnosis in DSM-IV that includes a set of symptoms experienced by some individuals shortly after a traumatic event. Acute stress symptoms were found to be an excellent predictor of the subjects' posttraumatic stress symptoms 7–10 months after the traumatic event. RESULTS: According to the Stanford Acute Stress Reaction Questionnaire, 12 (33%) of the employees met criteria for the diagnosis of acute stress disorder. The acute stress symptoms were assessed within 8 days of the event, and posttraumatic stress symptoms of 32 employees were assessed 7 to 10 months later. METHOD: The participants in this study were 36 employees working in an office building where a gunman shot 14 persons (eight fatally). ![]() OBJECTIVE: Using the DSM-IV diagnostic criteria for acute stress disorder, the authors examined whether the acute psychological effects of being a bystander to violence involving mass shootings in an office building predicted later posttraumatic stress symptoms. ![]()
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