Acute stress disorder following an industrial accident

Acute stress disorder (ASD) was introduced as a new diagnostic category in the fourth edition of the Diagnostic and Statistical Manual of Mental Disor ders (DSM-IV; American Psychiatric Association. 1994), Despite some controv ersy regarding the symptom criteria of ASD, little empirical data have yet been published on this new category. The current research was designed to i nvestigate the prevalence, course, and phenomenology of this disorder follo wing an industrial accident. Acute stress reactions were investigated in 47 males following an explosion in an oil refinery. Assessments were conducte d by experienced clinicians at two points in time (2 weeks and 3 months pos ttrauma), Measures included a standardised structured interview (SI-PTSD) a nd three self-report scales assessing traumatic stress (IES), anxiety (BAI) , and depression (BDI), Six per cent of the sample met criteria for ASD at 2 weeks posttrauma, This lower-than-expected prevalence appeared to be a fu nction of low levels of avoidance behaviour. Those people present at the ti me of the explosion scored higher than those who were not present on clinic ian-rated measures of symptom severity, but not on self-report measures. A significant reduction in symptoms occurred between 2 weeks and 3 months pos ttrauma, and no subjects went on to develop PTSD, While the current study l argely supports the diagnostic criteria for ASD, considerable research rema ins to be done on this new category of traumatic stress reaction. In partic ular, the impact or early interventions in ameliorating the symptoms of acu te stress disorder and preventing the progression to PTSD should be the foc us of future research.