Journal article Open Access

The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors

Creamer, Mark; O'Donnell, Meaghan L.; Pattison, Phillipa

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      <creatorName>Creamer, Mark</creatorName>
      <creatorName>O'Donnell, Meaghan L.</creatorName>
      <givenName>Meaghan L.</givenName>
      <creatorName>Pattison, Phillipa</creatorName>
    <title>The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors</title>
    <date dateType="Issued">2004-04-01</date>
  <resourceType resourceTypeGeneral="JournalArticle"/>
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    <relatedIdentifier relatedIdentifierType="DOI" relationType="IsIdenticalTo">10.1016/s0005-7967(03)00141-4</relatedIdentifier>
    <rights rightsURI="info:eu-repo/semantics/openAccess">Open Access</rights>
    <description descriptionType="Abstract">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.</description>
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