Acute stress disorder after burn injury: a predictor of posttraumatic stress disorder?
OBJECTIVE
The principal goals of this study were to determine whether ASD predicted chronic PTSD and whether dissociation is more characteristic of the acute-trauma period than PTSD symptoms.


METHODS
Eighty-three hospitalized adult burn patients were assessed with structured interviews and self-report measures within 2 weeks of injury and again at least 6 months postburn.


RESULTS
Nineteen percent had ASD. Dissociative symptoms were not more common or more severe than PTSD symptoms. Thirty-six percent had chronic PTSD. While ASD predicted chronic PTSD, meeting the symptom criteria for PTSD within 2 weeks postburn also predicted chronic PTSD.


CONCLUSIONS
Our data support the inclusion of an ASD diagnosis in the DSM, which would allow the diagnosis of symptoms in the first month posttrauma as a psychiatric disorder but questions whether dissociation is more characteristic of the acute trauma period than the PTSD symptom clusters.
Difede
JoAnn
J
Department of Psychiatry and William Randolph Hearst Burn Center, The New York Presbyterian Hospital, New York, NY 10021, USA. jdifede@med.cornell.edu
Ptacek
J T
JT
Roberts
Jennifer
J
Barocas
Daniel
D
Rives
Wendy
W
Apfeldorf
William
W
Yurt
Roger
R
D000328:Adult; D002056:Burns / Q000523:psychology* / Q000534:rehabilitation; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D040701:Stress Disorders, Traumatic, Acute / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires