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A. The person
has been exposed to a traumatic event in which both of the following
were present:
1) 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, and
2) 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 re-experienced in one (or more) 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 on awakening or when intoxicated).
Note: In young children,
trauma-specific reenactment may occur
4) intense psychological distress at exposure
to internal or eternal cues that symbolize or resemble an aspect
of the traumatic event.
5) physiological reactivity on exposure to
internal or external cures 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:
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
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 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:
1) difficulty
falling or staying asleep
2) irritability or outbursts of anger
3) difficulty concentrating
4) hypervigilance
5) exaggerated startle response
E. Duration
for the disturbance (symptoms in criteria B, C and D) is more
than one month.
F. The disturbance
causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
Acute —
duration of symptoms is less than three months
Chronic — duration of symptoms is more
than three months
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Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Copyright 1994 American Psychiatric Association.
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