Criterion A: Traumatic Event

Criterion B: Intrusion or Re-Experiencing

Trauma survivors must have been exposed to actual or threatened:

Ÿ Direct exposure

Ÿ Witnessing the trauma

Ÿ Learning that a relative or close friend was exposed to trauma

Ÿ Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)

These symptoms envelope ways that someone re-experiences the event. This could look like:

Ÿ Unwanted upsetting memories

Ÿ Nightmares

Ÿ Emotional distress after the exposure to traumatic reminders

Ÿ Physical reactivity after exposure to traumatic reminders

Ÿ Psychological and physical reactivity to reminders of the traumatic event, such as an anniversary

The exposure can be:

Ÿ direct

Ÿ witnessed

Ÿ indirect, by hearing of a relative or close friend who has experienced the event—indirectly experienced death must be accidental or violent

Ÿ repeated or extreme indirect exposure to qualifying events, usually by professionals—non-professional exposure by media does not count

Criterion C: Avoidant Symptoms

Criterion D: Negative Alterations in Mood or Cognitions

Avoidant symptoms describe ways that someone may try to avoid any memory of the event, and must include one of the following:

Ÿ Avoiding thoughts or feelings

Ÿ Avoiding people or situations connected to the traumatic event

This criterion is new but captures many symptoms that have long been observed by PTSD sufferers and clinicians. Basically, there is a decline in someone’s mood or thought patterns, which can include:

Ÿ Memory problems that are exclusive to the event

Ÿ Negative thoughts or beliefs about one’s self or the world

Ÿ Distorted sense of blame for one’s self or others, related to the event

Ÿ Negative Affect

Ÿ Decreased interest in activities

Ÿ Feeling isolated or disconnected from other people

Ÿ Difficulty experiencing positive affect

Criterion E: Increased Arousal Symptoms

Criteria F, G and H

Increased arousal symptoms are used to describe the ways that the brain remains “on edge,” wary and watchful of further threats. Symptoms include the following:

Ÿ Irritability or aggression

Ÿ Risky or destructive behaviors

Ÿ Difficulty falling or staying asleep

Ÿ Heightened startle reaction

Ÿ Hypervigilance

Ÿ Difficulty concentration

These criteria all describe the severity of the symptoms listed above. Symptoms create distress or functional impairment (e.g., social, occupational). Basically, they have to have lasted at least a month, seriously affect one’s ability to function and can’t be due to substance use, medical illness or anything except the event itself.