Assessing Acute Stress Symptoms

Since the acute stress disorder (ASD) diagnosis was introduced in the fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), there has been considerable research on and clinical attention to the role of acute traumatic stress responses. This chapter commences with an overview of the history of ASD, including its rationale and its initial diagnostic definition. It provides an outline of findings accrued since ASD’s introduction, and particularly regarding the structure of ASD, its relationship to subsequent posttraumatic stress disorder (PTSD), and the evidence regarding the role of dissociation. The changes to the conceptualization and definition of ASD in DSM-5 are outlined. The available measurement tools for acute stress reactions are then discussed, although at the current time these have not yet been validated for the DSM-5 criteria. Additional important evidence regarding acute traumatic stress is also reviewed, including how biological and cognitive factors need to be considered when conducting an assessment of people in the acute period after trauma exposure.