DSM-5 Diagnostic Criteria for PTSD

DSM-5 Criteria for PTSD National Center for PTSD, U.S. Department of Veterans Affairs. In 2013, the American Psychiatric Association revised the PTSD diagnostic criteria in the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

PTSD is included in a new category in the DSM-5, Trauma- and Stressor-Related Disorders. All the conditions included in this classification require exposure to a traumatic or stressful event as a diagnostic criterion.

NOTE: Diagnosis of PTSD or any other disorder can only be made by a Registered Psychologist with specific and formal clinical training or a Psychiatrist or Medical Doctor. Please exercise caution when reviewing the following as it is a common occurrence for non-professionals to assume they meet the criteria.

All the criteria are required for the diagnosis of PTSD.

The following text summarizes the diagnostic criteria:

 

Criterion A: stressor (one required)

  • The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s):

Direct Exposure:

  • Witnessing the trauma
  • Learning that a relative or close friend was exposed to a trauma

Indirect Exposure:

  • to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics)  

 

Criterion B: intrusion symptoms (one required)

The traumatic event is persistently re-experienced in the following way(s):

  • Unwanted upsetting memories
  • Nightmares
  • Flashbacks
  • Emotional distress after exposure to traumatic reminders
  • Physical reactivity after exposure to traumatic reminders  

 

Criterion C: avoidance (one required)

Avoidance of trauma-related stimuli after the trauma, in the following way(s):

  • Trauma-related thoughts or feelings
  • Trauma-related external reminders  

 

Criterion D: negative alterations in cognitions and mood (two required)

Negative thoughts or feelings that began or worsened after the trauma, in the following way(s):

  • Inability to recall key features of the trauma
  • Overly negative thoughts and assumptions about oneself or the world
  • Exaggerated blame of self or others for causing the trauma
  • Negative affect
  • Decreased interest in activities
  • Feeling isolated
  • Difficulty experiencing positive affect

 

Criterion E: alterations in arousal and reactivity Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s):

  • Irritability or aggression
  • Risky or destructive behavior
  • Hypervigilance
  • Heightened startle reaction
  • Difficulty concentrating
  • Difficulty sleeping

 

Criterion F: Duration (required)

  • Symptoms last for more than 1 month.

 

Criterion G: Functional Significance (required)

  • Symptoms create distress or functional impairment (e.g., social, occupational).

 

Criterion H: exclusion (required) Symptoms are not due to medication, substance use, or other illness.

Two specifications:

  • Dissociative Specification:  In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli:
  • Depersonalization: Experience of being an outside observer of or detached from oneself (e.g., feeling as if “this is not happening to me” or one were in a dream).
  • Derealization: Experience of unreality, distance, or distortion (e.g., “things are not real”).
  • Delayed Specification: Full diagnostic criteria are not met until at least six months after the trauma(s), although onset of symptoms may occur immediately.