By Richard A. Bryant PhD
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Extra info for Acute Stress Disorder: What It Is and How to Treat It
In drawing support for the importance of dissociation in acute (and for that matter, chronic) responses to trauma, proponents drew an array of sources of evidence. Much energy was given to the reported prevalence of trauma histories in those presenting with dissociative symptoms (Coons & Milstein, 1984; Kluft, 1987), and particularly with severe dissociative Diagnosis of ASD 25 disorders. In the wake of the explosion of reported repressed memories of sexual assaults (often from cultic or ritualistic situations), patients were being identified with multiple personalities, repressive amnesia of the most grotesque histories, and dissociative states in their everyday lives at a level not previously witnessed.
The fourth symptom grouping includes the avoidance symptoms. Again, this was similar to the DSM-IV items, but they were more clearly specified by delineating avoidance of internal reminders (such as traumarelated thoughts or emotions) and avoidance of external reminders (such as situations or conversations reminiscent of the trauma). In DSM-IV this was globally referred to as “marked” avoidance, however, in DSM-5 this reaction was given greater numerical weight by having them recognized as two separate items in the potential list of symptoms.
This indicates that the majority of trauma survivors who eventually developed PTSD did not meet the full criteria for ASD. This conclusion suggests that if a major goal of ASD is to predict people who will subsequently develop PTSD, it is failing to identify the majority of those who will meet criteria for PTSD at some later time. Why is this the case? There are several possible explanations. 1). These figures suggest that the sensitivity is superior if one adopts a subsyndromal 32 Harvey et al.
Acute Stress Disorder: What It Is and How to Treat It by Richard A. Bryant PhD