Post Traumatic Stress Disorder: Understanding the Diagnostic Criteria

By: Abby Erasmus

Post- traumatic stress disorder is a psychiatric disorder that individuals can develop after experiencing a traumatic event. Traumatic events are defined by incidents that have the capacity to provoke fear, helplessness, or horror in response to the threat of injury or death. Further, as stated in the Diagnostic and Statistical Manual of Mental Disorders (5th ed; DSM- 5; American Psychiatric Association, 2013), one must display 4 types of symptoms to be diagnosed with post- traumatic stress disorder.

The first type is symptoms of re-experiencing the event in which the individual has unwanted recollections of the event (i.e. nightmares). The second type is symptoms of avoidance that include avoiding thoughts and feelings in regard to the incident as well as external reminders of the event (i.e. people, places). The next type of symptoms is symptoms of negative alterations in cognition and mood associated with the traumatic event (i.e. exaggerated negative beliefs/ expectations about oneself). Lastly, individuals will experience marked alterations in arousal and reactivity associated with the event (i.e. exaggerated startle response). Additional criteria includes length of symptoms in which symptoms should persist for longer than one month, severity of symptoms in which they should cause significant clinical distress, and cause of disorder such that symptoms should not be linked to the effects of drugs or substances.

It is also important to note that individuals can have a “delayed expression” of post-traumatic stress disorder (PTSD), which, according to the DSM-5, occurs when the “full diagnostic criteria [of PTSD] are not met until at least 6 months after the event” (APA, 2013). To restate, symptoms can manifest long after this 6 month window. The DSM-5 also states that having had a prior psychiatric disorder such as depression, and emotional problems such as anxiety problems, serve as risk factors in developing PTSD after one experiences a traumatic event. This relationship also works in reverse; experiencing a traumatic puts one at an increased risk for developing other psychiatric disorders such as generalized anxiety disorder (GAD), and at risk for the worsening of GAD symptoms if they had been diagnosed prior to the PTSD diagnosis.

If you or someone you know is seeking therapy for post- traumatic stress disorder, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/          

Sources:

https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/

https://www.nejm.org/doi/full/10.1056/NEJMra012941

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