Post-Traumatic Stress Disorder (PTSD)

The following is a list of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for PTSD. All of the following diagnostic criteria are required to be present for the diagnosis of PTSD and symptoms must have been present for at least one month.

 

Criterion A: stressor (one required).

The person was exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

• Direct experience/exposure to traumatic even

• Witnessing the trauma

• Learning that the traumatic events happened to close friend or family member

• Experiencing repeated extreme exposure to aversive details of the trauma, often in the course of professional duties (e.g., first responders, medics, police, physicians, etc)

 

Criterion B: Intrusive symptoms (at least one required).

The traumatic event is persistently re-experienced in the following way(s):

• Unwanted distressing memories

• Distressing dreams or nightmares

• Flashbacks (dissociative reactions during which a person re-experiences the trauma)

• Intense psychological/emotional distress after exposure to traumatic reminders

• Physical reactivity after exposure to reminders of the traumatic event

 

Criterion C: Avoidance (one required) of trauma-related stimuli after the trauma, in the following way(s):

• Avoidance of trauma-related thoughts, memories, or feelings

• Avoidance of trauma-related external reminders

 

Criterion D: Negative alterations in cognitions and mood (two required).

Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

• Inability to recall important features of the trauma

• Persistent negative thoughts and assumptions about oneself, others or the world

• Distorted thinking and blame of self or others for causing the trauma

• Persistent negative affect (emotional state)

• Decreased interest and participation in activities

• Feeling of isolation and detachment from others

• Difficulty experiencing positive affect (emotional states)

 

Criterion E: alterations in arousal and reactivity

Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

• Irritability, anger, or aggression

• Destructive or reckless behavior

• Hypervigilance

• Exaggerated startle reaction

• Issues with concentrating

• Difficulty falling or staying asleep

 

Criterion F: Duration of symptoms (required).

Symptoms last for more than 1 month.

 

Criterion G: Functional Impairment.

Symptoms create distress or functional impairment (e.g., social, occupational).

 

Criterion H: Exclusion (required).

Symptoms are not due to medication, substance use, or other illness.

Two specifications:

• Dissociative Specification. In addition to meeting diagnosis criteria, the individual experiences high levels of one or both of the following in reaction to trauma-related stimuli:

  • Depersonalization: The experience of being detached or as if an outside observer from oneself (e.g. feeling as if it is all a dream).

  • Derealization: Experience of unreality of experiences (e.g. feeling as if things are not real).

• Delayed Specification. Full diagnostic criteria are not met until at least 6 months after the trauma(s), although symptom onset may immediately occur.