Post Traumatic Stress Disorder
Exposure to Trauma
The patient was exposed to a traumatic event in which both of these situations occurred:
• The patient experienced, witnessed, or was confronted with an event that involved actual or threatened death or serious injury or a threat to the physical integrity of the self or others.
• The patient’s response involved intense fear, helplessness, or horror.
Reexperiencing of the Trauma
The patient persistently reexperiences the traumatic event in at least one of these ways:
• recurrent and intrusive distressing recollections of the event, such as images, thoughts, or perceptions
• recurrent distressing dreams of the event
• acting or feeling as if the traumatic event were recurring (such as a sense of reliving the experience, illusions, hallucinations, and dissociative episodes that occur even on awakening or when intoxicated)
• intense psychological distress at exposure to internal or external cues that symbolize or resemble some aspects of the traumatic event.
Avoidance of Reminders
The patient persistently avoids stimuli associated with the trauma. She also experiences numbing of general responsiveness (not present before the traumatic event), as shown by at least three of these criteria:
• efforts to avoid thoughts or feelings associated with trauma
• efforts to avoid activities, places, or people that arouse recollections of the trauma
• inability to recall an important aspect of the traumatic event
• markedly diminished interest in significant activities
• feeling of detachment or estrangement from other people
• restricted range of affect-for instance,, inability to love others
• sense of a foreshortened future
The patient has persistent symptoms of increased arousal (not present before the trauma), as shown by at least two of these criteria:
• difficulty falling or staying asleep
• irritability or angry outbursts
• difficulty concentrating
• exaggerated startle response.
• The duration of the disturbance is at least 1 month.
• The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.