What is PTSD

PTSD, Post Traumatic Stress Disorder, is defined precisely as it sounds, stress derived after witnessing a traumatic event.

But what is that exactly?  

The Diagnostic and Statistical Manual of Mental Disorders (DSM), per the American Psychiatric Association states the critera to be diagnosed with PTSD is:

Criterion A (one required)  

The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

• Direct exposure

• Witnessing the trauma

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

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

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Criterion B (one required)  

The traumatic event is persistently re-experienced, in the following way(s):

• Unwanted upsetting memories

• Nightmares

• Flashbacks

• Emotional distress after exposure to traumatic reminders

• Physical reactivity after exposure to traumatic reminders

Criterion C (one required)  

Avoidance of trauma-related stimuli after the trauma, in the following way(s):

• Trauma-related thoughts or feelings

• Trauma-related reminders

Criterion D (two required)  

Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

• Inability to recall key features of the trauma

• Overly negative thoughts and assumptions about oneself or the world

• Exaggerated blame of self or others for causing the trauma

• Negative affect

• Decreased interest in activities

• Feeling isolated

• Difficulty experiencing positive affect

Criterion E (two required)  

Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

• Irritability or aggression

• Risky or destructive behavior

• Hypervigilance

• Heightened startle reaction

• Difficulty concentrating

• Difficulty sleeping

Criterion F (required) 

Symptoms last for more than 1 month.

Criterion G (required) 

Symptoms create distress or functional impairment (e.g., social, occupational).

Criterion H (required) 

Symptoms are not due to medication, substance use, or other illness.

Two specifications:

• Dissociative Specification. In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli:

  • Depersonalization. Experience of being an outside observer of or detached from oneself (e.g., feeling as if "this is not happening to me" or one were in a dream).

  • Derealization. Experience of unreality, distance, or distortion (e.g., "things are not real").
     

• Delayed Specification. Full diagnostic criteria are not met until at least six months after the trauma(s), although onset of symptoms may occur immediately.