What is PTSD

Post Traumatic Stress Disorder (PTSD) is a mental health diagnosis in the Diagnostic and Statistical Manual (DSM) used in the United States and the International Classification of Diseases (ICD). The definition of PTSD has been a topic of debate within the mental health community and has changed over the last few decades. Additionally, the current DSM-V and the soon to be released ICD-11 have taken different approaches in defining PTSD.

Where there is agreement and consistency...

  1. The definition of trauma - exposure to an extreme stressor involving direct personal experience of an event that involves actual or threatened death, serious injury, or threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning that a traumatic event occurred to a close family member or friend.
  2. Symptoms have been present for more than 1 month and cause significant distress or impairment in social, occupational, or other important areas of functioning. Symptoms must include:
    1. Intrusion
      1. Recurrent, involuntary, intrusive, distressing memories of the event
      2. Recurrent, distressing dreams related to the event
      3. Flashbacks
      4. Distressed emotional or physiological reactions when exposed to reminders of the event (triggers)
    2. Avoidance
      1. Efforts to avoid distressing memories, thoughts, or feelings about the traumatic event
      2. Efforts to avoid reminders that arouse distressing memories, thoughts, or feelings about the traumatic event
    3. Increased Arousal or Sense of Threat
      1. Irritability or outbursts of anger
      2. Hypervigilance
      3. Difficulty falling or staying asleep
      4. Difficulty concentrating
      5. Exaggerated startle response

The DSM-V has added the following:

  • Negative alterations in cognitions and mood associated with the traumatic event
    • Inability to remember important aspects of the event
    • Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world
    • Persistent, distorted, cognitions about the cause or consequences of the event that lead the individual to blame themselves or others
    • Persistent negative emotional state
    • Markedly diminished interest or participation in significant activities
    • Feelings of detachment or estrangement from others
    • Persistent inability to experience positive emotions
  • A specifier of "with dissociative symptoms" that includes "depersonalization" and "derealization."