In the prelude to DSM-5, it is appropriate to review the utility of ASD as a diagnosis and to determine the extent to which it adds value to the current diagnosis of PTSD. This Article first appeared in epub ahead of print.)Īcute stress disorder (ASD) was introduced in DSM-IV as a new diagnosis to describe acute stress reactions (ASRs) that may precede posttraumatic stress disorder (PTSD). (This Article is being co-published by Depression & Anxiety and the American Psychiatric Association. It is proposed that ASD may be better conceptualized as the severity of acute stress responses that does not require specific clusters to be present. The evidence suggests that the current emphasis on dissociation may be overly restrictive and does not recognize the heterogeneity of early posttraumatic stress responses. It is proposed that ASD be limited to describing severe ASRs (that are not necessarily precursors of PTSD). This review presents a number of options and preliminary considerations to be considered for DSM-5. The evidence suggests that ASD does not adequately identify most people who develop PTSD. This review considers ASD in relation to other diagnostic approaches to acute stress responses, critiques the evidence of the predictive power of ASD, and discusses ASD in relation to Adjustment Disorder. Acute stress disorder (ASD) was introduced into DSM-IV to describe acute stress reactions (ASRs) that occur in the initial month after exposure to a traumatic event and before the possibility of diagnosing posttraumatic stress disorder (PTSD), and to identify trauma survivors in the acute phase who are high risk for PTSD.
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