Appendix E

DSM-IV
Diagnostic criteria for 308.3 Acute Stress Disorder

1. The person has been exposed to a traumatic event in which both of the following were present:
   1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
   2. The person’s response involved fear, helplessness, or horror
2. Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociative symptoms:
   1. A subjective sense of numbing, detachment, or absence of emotional responsiveness
   2. A reduction in awareness of his or her surroundings (e.g., “being in a daze”)
   3. De-realisation
   4. Depersonalisation
   5. Dissociative amnesia (i.e., inability to recall an important aspect of the trauma)
3. The traumatic event is persistently re-experienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or distress on exposure to reminders of the traumatic event.
4. Marked avoidance of stimuli that arouse recollections of the trauma (e.g., thoughts, feelings, conversations, activities, places, people).
5. Marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness).