Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:ġ. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).ĭ. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).Ģ. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:ġ. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).Ĭ. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).ĥ. Note: In children, trauma-specific reenactment may occur in play.Ĥ. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.

Note: In children, there may be frightening dreams without recognizable content.ģ. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). Note: In children older than six years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.Ģ. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Presence of one (or more) of the following intrusion syndromes associated with the traumatic event(s), beginning after the traumatic event(s) occurred:ġ. Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.ī. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains police officers repeatedly exposed to details of child abuse). In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental.Ĥ. Learning that the traumatic event(s) occurred to a close family member or close friend. Witnessing, in person, the event(s) as it occurred to others.ģ. Directly experiencing the traumatic event(s).Ģ. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:ġ.

Primary care physicians should monitor patients with PTSD for comorbid conditions such as substance abuse, mood disorders, and suicidality, and should refer patients to behavioral health specialists and support groups when appropriate.Ī. Benzodiazepines and atypical antipsychotics are not recommended because studies have shown that adverse effects outweigh potential health benefits. For patients who meet criteria for PTSD, trauma-focused psychotherapy and pharmacotherapy improve symptoms. Self-report questionnaires can assist clinicians in identifying anxiety problems associated with traumatic events. The hallmarks of PTSD include exposure to a traumatic event reexperiencing the event or intrusion symptoms avoidance of people, places, or things that serve as a reminder of the trauma negative mood and thoughts associated with the trauma and chronic hyperarousal symptoms. PTSD is a trauma- and stress-related disorder associated with significant psychosocial morbidity, substance abuse, and other negative physical health outcomes. Posttraumatic stress disorder (PTSD) occurs in an estimated 8% of men and 20% of women who are exposed to traumatic events.

Dsm 5 criteria for current severe ptsd