By Richard A. Bryant PhD
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Additional info for Acute Stress Disorder: What It Is and How to Treat It
We can see that in this sense the ASD performs moderately well in predicting later PTSD. However, the sensitivity across most studies was poor. This indicates that the majority of trauma survivors who eventually developed PTSD did not meet the full criteria for ASD. This conclusion suggests that if a major goal of ASD is to predict people who will subsequently develop PTSD, it is failing to identify the majority of those who will meet criteria for PTSD at some later time. Why is this the case? There are several possible explanations.
One can experience the symptoms of ASD in mild form, and unless they are distressing or impairing, then the diagnostic criteria are not satisfied. The issue of impairment in psychiatric disorder has been debated at length over recent years—for example, Jerry Wakefield (1992, 1997) has argued that central to any psychiatric disorder is its capacity to identify that it is distinguished from normal functioning, and that the dysfunction within the individual is responsible for impairments in the ability to function at some observable level.
This outcome led to the conclusion that in DSM-5, ASD should not attempt to predict subsequent PTSD. Instead, its goal should explicitly be limited to describing acute stress reactions that were severe enough to warrant mental health support. ASD in DSM-5 Once the decision was made to abandon the goal of predicting PTSD, several other issues needed to be agreed on. One issue debated at length was whether ASD should be limited to fear or posttraumatic stress reactions rather than adopting a broader approach to recognize other psychological responses in the acute phase.