Jp. Staab et al., ACUTE STRESS DISORDER, SUBSEQUENT POSTTRAUMATIC-STRESS-DISORDER AND DEPRESSION AFTER A SERIES OF TYPHOONS, Anxiety, 2(5), 1996, pp. 219-225
From August to November 1992, five typhoons struck the U.S. Pacific is
land territory of Guam. Three hundred and twenty subjects exposed to a
ll five typhoons participated in a population survey measuring their a
cute stress symptoms and subsequent diagnoses of posttraumatic stress
disorder (PTSD) and depression. A 23-item scale approximating the new
DSM-IV diagnosis of acute stress disorder (ASD) was used to classify s
ubjects into three groups based on their symptoms one week after the f
irst typhoon: (I) probable ASD, (2) an early traumatic stress response
(ETSR) of fear intrusion, avoidance, and arousal, without dissociatio
n, and (3) no acute diagnosis. A multi-dimensional measure of PTSD and
the Zung Self-Rating Depression Scale were used to assess PTSD and de
pression 8 months after the first storm. The point prevalence of ASD a
t one week was 7.2%. An additional 15% of subjects had ETSR. Subjects
with probable ASD at one week had significantly increased rates of PTS
D and somewhat higher rates of depression at 8 months than those witho
ut ASD. In contrast, subjects with ETSR at one week did not have a poo
rer outcome than those with no acute diagnosis. These findings suggest
that ASD is prognostically important, but also indicate that all acut
e stress symptoms do not have the same discriminative value. lit this
study, the acute dissociative symptoms of emotional numbing and dereal
ization differentiated highly symptomatic subjects at risk for subsequ
ent psychopathology (ASD) from others who were highly symptomatic at o
ne week, but then had a more benign, posttraumatic course (ETSR). (C)
1996 Wiley-Liss, Inc.