Who develops acute stress disorder after accidental injuries?
BACKGROUND
Acute stress disorder (ASD) is still a much discussed diagnosis, and research on predictors of ASD is sparse. The aim of this study was to assess the prevalence of ASD in a random sample of accident victims and to investigate the associations between different independent variables and ASD symptomatology with the objective to find a regression model best explaining the variance in ASD symptom level.


METHODS
We collected a randomized sample of hospitalized accident victims (n = 323). ASD was assessed using the Peritraumatic Dissociative Experiences Questionnaire and the Clinician-Administered Posttraumatic Stress Disorder Scale. Correlations and multiple regression analyses were computed with four groups of variables. This yielded the variables entered into a final multiple regression analysis.


RESULTS
Thirteen patients (4.0%) met all criteria for a diagnosis of ASD. Thirty-two patients (9.9%) met the criteria for a diagnosis of subsyndromal ASD. Thirty-eight percent of the variance in ASD symptom level was explained with a regression model including stay at the intensive care unit, preexisting psychiatric disorder, sense of coherence, sense of death threat, appraisal of accident severity, preventability of the accident by others, pain and appraisal of coping ability regarding physical recovery.


CONCLUSIONS
This study furthers the discussion about the requirements for the ASD diagnosis. It also points to the importance of not only assessing objective accident-related variables in the aftermath of an accident but also of giving more consideration to the subjective experience and appraisal of the accident in the prevention of ASD.
Fuglsang
Annette Kjaer
AK
Institute of Psychology, University of Aarhus, Risskov, Denmark. annet@psy.au.dk
Moergeli
Hanspeter
H
Hepp-Beg
Sofia
S
Schnyder
Ulrich
U
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D013997:Time Factors; D014947:Wounds and Injuries / Q000150:complications / Q000175:diagnosis / Q000523:psychology*