Download DSM-IV-TR criteria for PTSD

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PTSD
In 2000, the American Psychiatric Association revised the PTSD diagnostic criteria in the fourth
edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)(1). The diagnostic
criteria (A-F) are specified below.
Diagnostic criteria for PTSD include a history of exposure to a traumatic event meeting two criteria
and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing
symptoms, and hyper-arousal symptoms. A fifth criterion concerns duration of symptoms and a
sixth assesses functioning.
Criterion A: stressor
The person has been exposed to a traumatic event in which both of the following have been
present:
1. The person has experienced, witnessed, or been confronted with an event or events that
involve actual or threatened death or serious injury, or a threat to the physical integrity of
oneself or others.
2. The person's response involved intense fear,helplessness, or horror. Note: in children, it
may be expressed instead by disorganized or agitated behavior.
Criterion B: intrusive recollection
The traumatic event is persistently re-experienced in at least one of the following ways:
1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or
perceptions. Note: in young children, repetitive play may occur in which themes or aspects
of the trauma are expressed.
2. Recurrent distressing dreams of the event. Note: in children, there may be frightening
dreams without recognizable content
3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the
experience, illusions, hallucinations, and dissociative flashback episodes,including those
that occur upon awakening or when intoxicated). Note: in children, trauma-specific
reenactment may occur.
4. Intense psychological distress at exposure to internal or external cues that symbolize or
resemble an aspect of the traumatic event.
5. Physiologic reactivity upon exposure to internal or external cues that symbolize or resemble
an aspect of the traumatic event
Criterion C: avoidant/numbing
Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness
(not present before the trauma), as indicated by at least three of the following:
1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma
2. Efforts to avoid activities, places, or people that arouse recollections of the trauma
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3. Inability to recall an important aspect of the trauma
4. Markedly diminished interest or participation in significant activities
5. Feeling of detachment or estrangement from others
6. Restricted range of affect (e.g., unable to have loving feelings)
7. Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or
a normal life span)
Criterion D: hyper-arousal
Persistent symptoms of increasing arousal (not present before the trauma), indicated by at least
two of the following:
1. Difficulty falling or staying asleep
2. Irritability or outbursts of anger
3. Difficulty concentrating
4. Hyper-vigilance
5. Exaggerated startle response
Criterion E: duration
Duration of the disturbance (symptoms in B, C, and D) is more than one month.
Criterion F: functional significance
The disturbance causes clinically significant distress or impairment in social, occupational, or other
important areas of functioning.
Specify if:
Acute: if duration of symptoms is less than three months
Chronic: if duration of symptoms is three months or more
Specify if:
With or Without delay onset: Onset of symptoms at least six months after the stressor
References
1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental
disorders (Revised 4th ed.). Washington, DC: Author.
Date Created: 07/05/2007 See last Reviewed/Updated Date below.
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Please see: Where to Get Help for PTSD
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New Diagnostic Criteria for PTSD to Be Released: DSM-5 - NATIONA...
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http://www.ptsd.va.gov/professional/pages/diagnostic_criteria_dsm-5.asp
PTSD
The Diagnostic and Statistical Manual of Mental Disorders provides standard criteria and
common language for the classification of mental disorders. It is published by the American
Psychiatric Association. The fifth revision (DSM-5) is scheduled to release in May 2013: This will
include changes to the diagnostic criteria for PTSD and Acute Stress Disorder.
The reason the PTSD criteria are being revised is to take into account the things we have learned
from scientific research and clinical experience.
What can we tell you now about those revisions?
Based on the proposed DSM-5 criteria, the prevalence of PTSD will be similar to what
it is currently in DSM-IV.
Symptoms are mostly the same. The 3 clusters of DSM-IV symptoms will be divided into
4 clusters in DSM-5: intrusion symptoms, avoidance symptoms, arousal/reactivity
symptoms and negative mood and cognitions. It is proposed that a few symptoms will be
added and some revised.
Criterion A2 (requiring fear, helplessness or horror happen right after the trauma) will be
removed.
The diagnosis is proposed to move from the class of anxiety disorders into a new class of
"trauma and stressor-related disorders."
PTSD assessment measures, such as the CAPS and the PCL, are being revised by the
National Center for PTSD to be made available upon the release of DSM-5.
Sign up for the PTSD Monthly Update to be informed when the new criteria and assessment
measures are officially released.
Sources
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders.
(4th ed., text revision). Washington, DC: Author.
Friedman, Matthew J; Resick, Patricia A; Bryant, Richard A; Brewin, Chris R (Sep 2011).
Considering PTSD for DSM-5. Depression and Anxiety 28. 9 : 750-769. http://www.ptsd.va.gov
/professional/articles/article-pdf/id35490.pdf PDF
Miller, Mark W; Wolf, Erika Jane; Kilpatrick, Dean G; Resnick, Heidi S; Marx, Brian P; et al. (Sep 3,
2012). The prevalence and latent structure of proposed DSM-5 posttraumatic stress disorder
symptoms in U.S. national and veteran samples. Psychological Trauma: Theory, Research,
Practice, and Policy. http://www.ptsd.va.gov/professional/articles/article-pdf/id39382.pdf PDF
Date Created: 12/05/2012 See last Reviewed/Updated Date below.
PTSD Site Map | Public Section | Professional Section | About Us: National Center for PTSD | Mobile Site
12/13/2012 10:46 AM