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D. At least 3 (or 2 in children) negative alterations in cognitions and mood that began or worsened
after the trauma(s):
• Inability to remember an important aspect of the trauma(s)
• Persistent and exaggerated negative expectations about one’s self, others, or the world
• Persistently excessive blame of self or others about the trauma(s)
• Pervasive negative emotional state
• Markedly diminished interest or participation in significant activities.
• Feeling of detachment or estrangement from others
• Persistent inability to experience positive emotions (e.g., unable to have loving feelings,
psychic numbing)
E. At least 3 (or 2 in children) of the following alterations in arousal and reactivity that began or
worsened after the trauma(s):
• Irritable or aggressive behavior
• Reckless or self-destructive behavior
• Hypervigilance
• Exaggerated startle response
• Problems with concentration
• Sleep disturbance -- for example, difficulty falling or staying asleep, or restless sleep
F. The symptoms began or worsened after the trauma(s) and continued for at least one month
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