Diagnostic Criteria for Posttraumatic Stress Disorder
- The person has been exposed to a traumatic event in which both the following were present:
- 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
- the person's response involved intense fear, helplessness, or horror.
Note: In children, this may be expressed instead by disorganized
or agitated behavior
- The traumatic event is persistently reexperienced in one (or more) of
the following ways:
- recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: ln young children, repetitive play may occur in which themes or aspects the trauma are expressed.
- recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.
- acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
- intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
- physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
- Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
- efforts to avoid thoughts, feelings, or conversations associated with the trauma
- efforts to avoid activities, places, or people that arouse recollections
of the trauma
- inability to recall an important aspect of the trauma
- markedly diminished interest or participation in significant activities
- feelings of detachment or estrangement from others
- restricted range of affect (e.g., unable to have loving feelings)
- sense of a foreshortened future (e.g., (does not expect to have a career, marriage, children, or a normal life span)
- Persistent symptoms of increased arousal (not present before the trauma), ss indicated by two (or more) of the following:
- difficulty falling or staying asleep
- irritability or outbursts of anger
- difficulty concentrating
- exaggerated startle response
- Duration of the disturbance (symptoms in Criteria B, C, and D) is more
than 1 month.
- The disturbance causes clinically significant distress or impairment in
social, occupational, or other important areas of functioning.
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor
From the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (Washington, DC: American Psychiatric Association, 1994)
National Center for PTSD
Psych Trauma pages, University of Queensland