Antecedents and consequences of acute stress disorder among motor vehicle accident victims.

The aim of this study was to examine differences between motor vehicle accident (MVA) victims diagnosed retrospectively with Acute Stress Disorder (ASD) and subsequent Post-Traumatic Stress Disorder (PTSD), and MVA victims with only PTSD. A total of 14 ASD subjects and 28 PTSD subjects (matched on age and on sex) were compared on subjects' levels of functioning and symptom severity at three time-points: pre-MVA, 1-4 months post-MVA (initial assessment), and 6 months post initial assessment. Fourteen non-MVA subjects were included as controls in the analyses for pre-MVA differences and presence of psychopathology at time of initial assessment. ASDs had higher rates of previous mood disorders (other than major depression), previous AXIS-I disorders, and previous AXIS-II disorders than did PTSDs. No differences existed between the groups at 6-month follow-up. These results provide clinically useful information regarding characteristics that predispose people to develop ASD in the aftermath of a trauma. Previous research with trauma victims has demonstrated dissociative symptoms to be associated with higher PTSD symptom severity and longer symptom duration, but our follow-up results suggest that ASD, which is characterized by dissociative symptomatology, is not indicative of poorer outcome in MVA victims.