Assessing Acute Traumatic Stress Symptoms

Abstract

AbstractThere is significant change in acute stress reactions in the weeks after exposure to a traumatic event, which raises challenges for assessing the responses in the acute posttraumatic period. This chapter reviews the assessment tools and strategies that are appropriate in the acute period. It focuses initially on acute stress disorder (ASD) as a description of acute posttraumatic stress and as a predictor of subsequent PTSD. Psychometrically-validated scales are reviewed for both diagnostic and symptom responses in the acute period, with a critique of the limited ability of these measures to identify most people who are at high risk for subsequent PTSD. Finally, this chapter identifies mechanisms that may enhance our ability to identify maladaptive responses in the acute phase, and specific populations that need particular attention in the immediate period following trauma exposure. The weeks following exposure to a traumatic event are often characterized by considerable distress, fluctuating emotions, and changing environmental factors. This lack of emotional and contextual stability raises significant challenges for assessment of psychological states shortly after trauma. This chapter aims to provide an overview of assessment of psychological responses in the weeks after trauma. It commences with a review of the current evidence about the nature of acute posttraumatic stress reactions and discusses the different goals of assessment at this stage. Established psychometric instruments are then reviewed, including structured clinical interviews, self-report measures, and other tools relevant to acute reactions. The review then turns to other factors that can be assessed, including cognitive and biological factors, occurring in the acute posttraumatic period. Finally, the chapter outlines other procedural issues that need to be considered when assessing trauma survivors in the acute phase.