Criterion A: The person has been exposed to a traumatic event in which both of the following were present: |
- 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.
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- The person's response involved intense fear, helplessness, or horror. NOTE: In children, this may be expressed instead by disorganized or agitated behavior.
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Criterion 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.
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- Recurrent distressing dreams of the event. NOTE: In children, there may be frightening dreams without recognizable content.
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- Acting or feeling as if the traumatic event were recurring (including a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on wakening or when intoxicated). NOTE: In young children, trauma-specific reenactment may occur.
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- Intense psychological distress and/or physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
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Criterion 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 conversations associated with the trauma.
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- Efforts to avoid activities, places, or people that arouse recollections of the trauma.
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- Inability to recall an important aspect of the trauma.
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- Markedly diminished interest in participating in significant activities.
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- Feeling detached or estranged from others.
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- Restricted range of effect (eg, unable to have loving feelings).
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- Sense of a foreshortened future (eg, does not expect to have a career, marriage, children, or a normal lifespan).
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Criterion D: Persistent symptoms of increased arousal (not present before trauma), as indicated by two (or more) of the following: |
- Difficulty falling or staying asleep.
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- Irritability or outbursts of anger.
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- Difficulty concentrating.
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- Hypervigilance.
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- Exaggerated startle response.
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Criterion E: Duration of the disturbance (symptoms in criteria B, C, and D) is more than one month |
Criterion F: 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. |
With delayed onset: If onset of symptoms is at least six months after the stressor. |