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Published in: Current Psychiatry Reports 12/2018

01-12-2018 | Disaster Psychiatry: Trauma, PTSD, and Related Disorders (MJ Friedman, Section Editor)

The Current Evidence for Acute Stress Disorder

Author: Richard A. Bryant

Published in: Current Psychiatry Reports | Issue 12/2018

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Abstract

Purpose of Review

The aim of this review is to provide a summary of the current evidence pertaining to the course of acute and chronic posttraumatic stress, the diagnosis of acute stress disorder (ASD), and treatment of acute stress disorder and prevention of posttraumatic stress disorder (PTSD).

Recent Findings

Although acute stress disorder was introduced partly to predict subsequent PTSD, longitudinal studies indicate that ASD is not an accurate predictor of PTSD. Recent analytic approaches adopting latent growth mixture modeling have shown that trauma-exposed people tend to follow one of four trajectories: (a) resilient, (b) worsening, (c) recovery, and (d) chronically distressed. The complexity of the course of posttraumatic stress limits the capacity of the ASD diagnosis to predict subsequent PTSD. Current evidence indicates that the treatment of choice for ASD is trauma-focused cognitive behavior therapy, and this intervention results in reduced chronic PTSD severity. Recent attempts to limit subsequent PTSD by early provision of pharmacological interventions have been promising, especially administration of corticosterone to modulate glucocorticoid levels.

Summary

Although the ASD diagnosis does not accurately predict chronic PTSD, it describes recently trauma-exposed people with severe distress. Provision of CBT in the acute phase is the best available strategy to limit subsequent PTSD.
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Metadata
Title
The Current Evidence for Acute Stress Disorder
Author
Richard A. Bryant
Publication date
01-12-2018
Publisher
Springer US
Published in
Current Psychiatry Reports / Issue 12/2018
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-018-0976-x

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