Acute Stress Disorder As a Predictor of
Posttraumatic Stress Symptoms.
Classen C; Koopman C; Hales R; Spiegel D
American Journal of Psychiatry, 155(5):650-624, 1998.
OBJECTIVE: Using the DSM-IV diagnostic criteria for acute stress
disorder, the authors examined whether the acute psychological effects
of being a bystander to violence involving mass shootings in an office
building predicted later posttraumatic stress symptoms.
METHOD: The participants in this study were 36 employees working in
an office building where a gunman shot 14 persons (eight fatally). The
acute stress symptoms were assessed within 8 days of the event, and
posttraumatic stress symptoms of 32 employees were assessed 7 to 10
RESULTS: According to the Stanford Acute Stress Reaction
Questionnaire, 12 (33%) of the employees met criteria for the diagnosis
of acute stress disorder. Acute stress symptoms were found to be an
excellent predictor of the subjects' posttraumatic stress symptoms 7-10
months after the traumatic event.
CONCLUSIONS: These results suggest not only that being a bystander to
violence is highly stressful in the short run, but that acute stress
reactions to such an event further predict later posttraumatic stress