Acute Stress Disorder was introduced into the mental health community with the publication of the DSM-IV. Upon first examination of the symptoms for Acute Stress Disorder (ASD), the criteria seem very similar to Posttraumatic Stress Disorder (PTSD). The two major differences between ASD and PTSD seem to be one of duration and the emphasis on emotional numbing and dissociation. Indeed, if a person is assessed immediately following a traumatic stressor, a diagnosis of ASD will be assigned. However if the symptoms persist beyond a month, then the diagnosis becomes PTSD. It is interesting how intertwined the two diagnoses are.
Following a serious car accident, severe dog bite, assault, and other traumatic events, Acute Stress is used to describe how a person initially responds to that trauma. Unlike PTSD, how to treat ASD has not been throughly researched. It is knows that many people with ASD will recover without any treatment. However, some research indicates that 80% of those people receiving an ASD diagnosis will develop PTSD within 6 months. How to reduce the likelihood of someone developing PTSD has been the debate. Frequently the traumatized individual receives treatment along a PTSD protocol. But this has been shown to be ineffective and possibly re-traumatizing. Critical Incident Stress Debriefing (CISD) was used to treat the September 11, 2001 responders, thinking that it was the most effective intervention available. CISD, in the long run, did not prove itself as a viable intervention.
It is true that in many disasters, war, and mass crises, effective interventions are not as needed as food, shelter, and safety. But what is an effective way to deal with the traumatized assault victim, the survivor of a car accident, or witness to a school shooting? Are there ways to make the following days easier for them? Why don’t PTSD interventions work when so many ASD suffers will later suffer from PTSD? It may be too early yet to know all the answers about ASD since it has only been around as a diagnosis since 1994. Recent research seems to show that cognitive behavioral interventions are having positive outcomes.
For a more complete discussion on Acute Stress Disorder see Briere, J. (2006) Principles of Trauma Therapy. (pp 165-183) London: Sage Publications.