Criterion A: Traumatic Event | Criterion B: Intrusion or Re-Experiencing |
Trauma survivors must have been exposed to actual or threatened: Direct exposure Witnessing the trauma Learning that a relative or close friend was exposed to trauma 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: Unwanted upsetting memories Nightmares Emotional distress after the exposure to traumatic reminders Physical reactivity after exposure to traumatic reminders Psychological and physical reactivity to reminders of the traumatic event, such as an anniversary |
The exposure can be: direct witnessed indirect, by hearing of a relative or close friend who has experienced the event—indirectly experienced death must be accidental or violent repeated or extreme indirect exposure to qualifying events, usually by professionals—non-professional exposure by media does not count |
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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: Avoiding thoughts or feelings 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: Memory problems that are exclusive to the event Negative thoughts or beliefs about one’s self or the world Distorted sense of blame for one’s self or others, related to the event Negative Affect Decreased interest in activities Feeling isolated or disconnected from other people 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: Irritability or aggression Risky or destructive behaviors Difficulty falling or staying asleep Heightened startle reaction Hypervigilance 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. |