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Acute Stress Disorder After Burn Injury: A Predictor of Posttraumatic Stress Disorder?

From the Department of Psychiatry and William Randolph Hearst Burn Center, The New York Presbyterian Hospital, New York, NY.

Address reprint requests to: JoAnn Difede, The New York Presbyterian Hospital, 525 E. 68th Street, Box 200, New York, NY 10021. Email: jdifede{at}med.cornell.edu

OBJECTIVES: The principal goals of this study were to determine whether ASD predicted chronic PTSD and whether dissociation is more characteristic of the acute-trauma period than PTSD symptoms.

METHODS: Eighty-three hospitalized adult burn patients were assessed with structured interviews and self-report measures within 2 weeks of injury and again at least 6 months postburn.

RESULTS: Nineteen percent had ASD. Dissociative symptoms were not more common or more severe than PTSD symptoms. Thirty-six percent had chronic PTSD. While ASD predicted chronic PTSD, meeting the symptom criteria for PTSD within 2 weeks postburn also predicted chronic PTSD.

CONCLUSIONS: Our data support the inclusion of an ASD diagnosis in the DSM, which would allow the diagnosis of symptoms in the first month posttrauma as a psychiatric disorder but questions whether dissociation is more characteristic of the acute trauma period than the PTSD symptom clusters.

Key Words: acute stress disorder, • burn injury, • posttraumatic stress disorder, • trauma.

Abbreviations: PTSD = posttraumatic stress disorder;; ASD = acute stress disorder;; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th ed.

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