Definition: Post-Traumatic Stress Disorder Symptoms

The diagnostic criteria for PTSD, per the Diagnostic and Statistical Manual of Mental Disorders IV (Text Revision) (DSM-IV-TR), may be summarized as:

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A. Exposure to a traumatic event

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B. Persistent reexperience (e.g. flashbacks, nightmares)

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C. Persistent avoidance of stimuli associated with the trauma (e.g. inability to talk about things even related to the experience. Avoidance of things and discussions that trigger flashbacks and reexperiencing symptoms. Fear of losing control and harming another person.)

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D. Persistent symptoms of increased arousal (e.g. difficulty falling or staying asleep, anger and hypervigilance)

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E. Duration of symptoms more than 1 month

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F. Significant impairment in social, occupational, or other important areas of functioning (e.g. problems with work and relationships.)

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Notably, criterion A (the "stressor") consists of two parts, both of which must apply for a diagnosis of PTSD. The first (A1) requires that "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 second (A2) requires that "the person’s response involved intense fear, helplessness, or horror." The DSM-IV-TR criterion differs substantially from the previous DSM-III-R stressor criterion, which specified the traumatic event should be of a type that would cause "significant symptoms of distress in almost anyone," and that the event was "outside the range of usual human experience." Since the introduction of DSM-IV, the number of possible PTSD traumas has increased and one study suggests that the increase is around 50%.

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