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Post-Traumatic Stress Disorder: Diagnostic Criteria

As we saw in Post-Traumatic Stress Disorder: What Causes It?, this condition is a relative newcomer to the list of registered psychological disorders, yet it has existed under a variety of names, including “shell-shock”, since time began. It was first termed “Post-Traumatic Stress Disorder” in 1980. But as far back as the 1600s, the great English diarist, Samuel Pepys, described the Great Fire of London and documented symptoms in the population of what we would now term PTSD.

Apart from natural disasters and wartime experiences, women who experience rape, sexual assault, aggravated assault, and robbery are particularly prone to the disorder. This is due to the sense of helplessness which women feel during these types of traumatic events. However not every person who experiences a trauma goes on to develop PTSD. Apart from individual differences, what happens after the crisis event is probably one of the determining factors as to whether a person will experience the disorder.

Keeping the traumatic event to oneself is one of the key factors in the development of PTSD. Unfortunately, men who witness horrendous sights during the course of their war experiences and women who are raped or otherwise sexually assaulted are probably the two least likely groups of people to be forthcoming in talking about their experiences. Hence these two scenarios make up a large component of the type of situations in which PTSD can arise.

In order to be given a diagnosis of PTSD the following criteria must be met:

  1. The person has been exposed to a traumatic event in which both the following are present :
    a) The person directly experienced or witnessed an event which involved real or threatened death or serious injury.
    b) The response to the event caused fear and a sense of helplessness.
  2. The traumatic event is re-experienced in at least one of the following ways:
    a) Recurrent, intrusive memories of the event.
    b) Recurrent distressing nightmares based on the event.
    c) Feelings consistent with re-living the traumatic event, including flashbacks.
    d) Extreme psychological distress when exposed to situations which remind the person of the traumatic event.
  3. Persistent attempts to avoid situations which stimulate memories of the original trauma, including:
    a) Attempts to avoid thinking, feeling, and talking about the trauma
    b) Attempts to avoid places, people, or activities associated with the trauma.
    c) Lowered interest in significant activities.
    d) Feelings of estrangement from others.
    e) Diminished range of emotional reactions, e.g., lack of ability to laugh heartily, express love deeply, etc.)
  4. Symptoms of increased arousal of the nervous system as demonstrated by:
    a) Difficulty falling or staying asleep.
    b) Irritability and sudden unexplained rages
    c) Difficulty concentrating.
    d) Hypervigilance (i.e. consistently on edge as if waiting for something to happen).
    e) Exaggerated startle response.
  5. Symptoms are present for at least one month, and cause significant problems in social, employment, and interpersonal relations.

Next article, we will examine preventative action as well as treatment options for sufferers of PTSD.


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