DSM 5 Posttraumatic Stress Disorder:

Criteria A:

PTSD is caused by trauma resulting from:

  1. direct experience
  2. witnessing in person an event as it happened to someone else,
  3. Learning a traumatic event occurred to close friend or family, or
  4. repeated direct or indirect exposure.

Criteria B: Intrusive symptoms (1 or more)

  1. Recurrent, Involuntary and Intrusive distressing memories and dreams
  2. Dissociative reactions, flashbacks, feelings or acts as if trauma reoccurs
  3. Intense distress and physiological reactions to triggers

Criteria C: Avoidance (1 or both)

  1. Avoidance or effort to avoid distressing memories, thoughts or feelings about a traumatic event
  2. Avoidance or effort to avoid external reminders (activities, objects, situations, etc).

Criteria D. Negative Alternations in Cognition and Mood (2 or more)

  1. Inability to remember aspects of trauma
  2. Persistent and exaggerated negative believes (no one is safe, all people are bad)
  3. Persistent, distorted views about the cause or consequences – Self blame
  4. Persistent negative emotional state (anger, horror, shame, guilt, fearful)
  5. Loss of interest in participation in activities
  6. Feeling detached from others
  7. Persistent inability to experience positive emotions

Criteria E. Alternations of Arousal (1 or more)

  1. Irritable behavior and angry outbursts
  2. Reckless or self-destructive tendencies
  3. Hypervigilance
  4. Exaggerated startle response
  5. Problems with concentration
  6. Sleep disturbances

Criteria F: Length of time

  • 1 month and longer / Here is the distinction between Acute Stress disorder and PTSD. Acute stress disorder is diagnosed when symptoms are 3 days to 1 month. An Other Trauma and Stressor related disorder is diagnosed when not all the criteria are met.

Criteria G: Impairment

  1. Cause distress or impairment in social, occupational or other important function

Criteria H:

  1. Independent of drug, alcohol or injury

Assessment strategies you might utilize to support your diagnosis

Common Assessment strategies

  1. For military personnel is the PTSD Checklist – Military Version (PCL-M) taken from the DSM-IV
  2. For Veterans, the Department of Veteran’s Affairs use VA Form 21-0960P-3 updated May 2018. The form is designed to assist clinicians enter additional information including an individual’s mental health history, injuries, depression, and comorbidity.

Evidence-based treatment interventions for this disorder

Common Evidence-Based Treatments used by the Department of Veteran’s Affairs are:

Cognitive Behavioral Therapy helps change (1) a person’s way of acting, (like smoking less or being more outgoing) (2) way of feeling: like helping a person to be less scared, less depressed, or less anxious (3) A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts (4) A way of dealing with physical or medical problems:

Cognitive Process Therapy (normally used to treat sexual trauma but is becoming more common in treating all forms of PTSD) help’s change thoughts and beliefs about trauma.

Mindfulness Meditation is another method used to treat the anxiety and hypervigilance related to PTSD.

Drug treatment therapy is coupled with psychological treatment. Drugs such as Prazosin are used to treat nightmares and Trazodone is used for sleep.

Resource:

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, Virginia: American Psychiatric Association Publishing
  • American Psychiatric Association. (2019). Online Assessment Measures. Retrieved from https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/assessment-measures#Level2
  • Department of Veteran Affairs. (2017). VA Form 21-0960P-3. Retrieved from: https://www.va.gov.vaforms/form_detail.asp?FormNo=21-0960P-3
  • National Center for Post-Traumatic Stress Disorder & Walter Reed Army Medical Center. (2004). Iraq War Clinician Guide, 2nd edition. United States: Department of Veterans Affairs & National Center for PTSD
  • Ray, W.J. (2018). Abnormal Psychology, 2nd edition. Thousand Oaks, California: Sage
  • Uniformed Services University & Center for Deployment Psychology. (2019). PTSD Checklist-Military Version (PCL-M). Retrieved from: https://deploymentpsych.org/system/files/member_resource/4-PCL-M.pdf

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