The Use of the National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS) to Assess the Prevalence and Predictability of Acute Stress Disorder in Trauma Patients

Abstract

Introduction: Acute Stress Disorder (ASD) causes symptoms like distractibility, irritability, and emotional detachment, lasting three days to one month after a traumatic event. In 2021, about 40 million emergency department (ED) visits were recorded for acute injuries, highlighting the need for stress quantification. The National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS) measures ASD severity in adults following extreme stress, with scores ≥14 indicating severe symptoms. Few studies have examined the NSESSS for trauma patients. We aim to assess the NSESSS's effectiveness in understanding trauma's impact on patient well-being, identifying patient improvement, and improving outcomes. Methods: This observational single-center study was conducted at a community hospital. Participants were at least 18 years old, arrived at the ED for acute injuries between January 2021 and December 2023, and consented to an ASD evaluation. Social workers administered the NSESSS upon hospital arrival, followed by a psychiatric evaluation within 48 hours. Patients were then reassessed by a psychiatrist with the NSESSS and DSM-5 criteria within seven days, with phone follow-ups for those discharged earlier. Statistical analysis was performed using SPSS software. Results: The study included 27 patients, 17 (63%) of whom were male, and 9 (27%) had pre-existing psychiatric comorbidities. The median age was 41 years (IQR 27-54), and the median NSESSS score was 6 (IQR 2-15). Among participants, 8 were true positives (NSESSS score ≥14 and met ASD DSM-5 criteria), 17 were true negatives (NSESSS score <14 and did not meet ASD DSM-5 criteria), and 2 were false negatives (NSESSS score <14 but met ASD DSM-5 criteria). There were no false positives. Conclusion: The NSESSS demonstrated internal consistency and validity, emerging as a promising tool for assessing ASD severity and tracking treatment progress in trauma patients. Early recognition and intervention for ASD are crucial in mitigating long-term adverse outcomes, highlighting the need for further research to understand its impact on patient well-being.