PTSD diagnostic criteria from the
Essential feature. Characteristic symptoms following a psychologically distressing event that is outside the range of usual human experience. The original stressor is usually experienced with intense fear, terror, and/or helplessness.
The precipitating stressor must not be one which is usually well tolerated by most other members of the cultural group (e.g., death of a loved one, ordinary traffic accident). Post-traumatic Stress Disorder need not develop in every victim. Traumas may be experienced alone, e.g., rape, severe physical assault) or in groups (e.g., military combat, unusually serious automobile accidents). The stressor may arise from natural, accidental, or purposeful events.
features. The disorder in children may present differently (see below).
Depression and anxiety are common and may be diagnosed as separate disorders.
Compulsive behavior or changes of routine or lifestyle may occur. Pseudo
-"organic" symptoms, such as memory problems, difficulty in concentrating, or
emotional liability, may occur and may be confused with Somatoform Disorders.
"Survivor's guilt" may occur, particularly if others were killed in the
traumatic event. Impairment may be mild or severe and may affect almost any
aspect of life. Phobic avoidance of real or symbolic reminders of the trauma may
diagnosis: If criteria for Anxiety Disorders, Depressive Disorders, or Organic
Mental Disorders are fully met, these diagnoses should also be made. "Adjustment
Disorder" implies a less severe trauma, and the patient does not meet all of the
criteria listed below.
for Post-Traumatic Stress Disorder:
A. The person has
experienced an event that is outside the range of usual human experience and
that would be markedly distressing to almost anyone.
B. The traumatic event
is persistently re-experienced in at least one of the following ways:
1. recurrent and
intrusive, distressing recollections of the event (in young children, repetitive
play in which themes or aspects of the trauma are expressed)
2. recurrent distressing
dreams of the event
3. sudden acting or
feeling as if the traumatic event were recurring (including "flashback" or
dissociative episodes, whether or not intoxicated)
4. intense psychological
distress at exposure to events that symbolize or resemble an aspect of the
traumatic event, including anniversaries
C. Persistent avoidance
of stimuli associated with the trauma or numbing of general responsiveness, as
indicated by at least three of the following:
1. efforts to avoid
thoughts or feeling associated with the trauma
2. efforts to avoid
activities or situations that arouse recollections of the trauma
3. inability to recall
an important aspect of the trauma (psychogenic amnesia)
4. markedly diminished
interest in significant activities (in young children, loss of recently acquired
developmental skills such as toilet training or language skills)
5. feeling of detachment
or estrangement from others
6. restricted range of
7. sense of
foreshortened future (e.g., the patient does not expect to live very long or to
have a successful career)
D. Persistent symptoms
of increased arousal (not present before the trauma), as indicated by at least
two of the following:
1. difficulty falling or
2. irritability or
outbursts of anger
4. hyper vigilance
5. exaggerated startle
activity upon exposure to events that symbolize or resemble an aspect of the
E. Duration of
disturbance (symptoms in "B," "C," and "D") of at least one month.
Specify: "delayed onset" if symptom onset occurs at least six months after the traumatic event. Age-specific features. The disorder in children may present differently.
Copyright © 1998-2004 A/101 AVN. All rights reserved. Revised: 08/22/04.