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All quotes are taken from the American
Psychiatric Association: Diagnostic and Statistical Manual of Mental
Disorders (DSM), Fourth Edition. Washington, DC, American Psychiatric
Association, 1994
Diagnostic Criteria:
A. "The person has been exposed to a traumatic
event in which both of the following were present:
- the person experience, 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 person's response involved intense fear,
helplessness, or horror. Note: In children, this may be expressed instead
by disorganized or agitated behavior.
B. The traumatic event is persistently reexperienced
in one (or more) of the following ways:
- 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.
- recurrent distressing dreams of the event.
Note: In children, there may be frightening dreams without recognizable
content.
- 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 on awakening or when intoxicated). Note:In young children, trauma
specific reenactment may occur.
- intense psychological distress at exposure
to internal or external cues that symbolize or resemble an aspect of the
traumatic event.
- physiological reactivity on exposure to internal
or external cues that symbolize or resemble an aspect of the traumatic
event.
C. Persistent avoidance of stimuli associated with
the trauma and numbing of general responsiveness (not present before
the trauma), as indicated by three (or more) of the following:
- efforts to avoid thoughts, feelings, or converstaions
associated with the trauma
- efforts to avoid activities, places, or people
that arouse recollections of the trauma
- inability to recall an important aspect of
the trauma
- markedly diminished interest or participation
in significant activities
- feeling of detachment or estrangement from
others
- restricted range of affect (e.g., unable to
have loving feelings)
- sense of a foreshortened future (e.g., does
not expect to have a career, marriage, children, or a normal life span)
D. Persistent symptoms of increased arousal (not
present before the trauma), as indicated by two (or more) of the following:
- irritability or outbursts of anger
- ddifficulty falling or staying asleep
- difficulty concentrating
- hypervigilance
- exaggerated startle response
Duration of the disturbance (symptoms in Criteria
B, C, and D) is more than 1 month.
The disturbance causes clinically significant distress
or impairment in social, occupational, or other important areas of functioning.
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