Diagnosing PTSD with the DSM-5

Criteria Clusters in Diagnosing PTSD

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), tells us there are eight criteria for diagnosing PTSD. The three criteria that must be present for a PTSD diagnosis are:

• The duration of symptoms is more than 1 month
• The disturbance causes clinically significant distress or impairment in functioning
• The disturbance is not attributable to the physiological effects of a substance or other medical condition

Diagnosing PTSD Criterion Cluster 1

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

• Directly experiencing the traumatic event(s)
• Witnessing the event(s) as it happened to other people
• Finding out traumatic event(s) happened to someone you care about
• Experiencing repeated or extreme exposure to details of the traumatic event(s) (e.g., police officers repeatedly exposed to details of child abuse, watching your partner abuse your children or children seeing the abuser hurt you, etc.)

PTSD Criterion Cluster 2

Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), sometimes called re-experiencing symptoms.

• Involuntary, and intrusive distressing memories of the event(s). Children older than 6, might show repetitive play in which themes or aspects of the traumatic event(s) are expressed.
• Recurrent distressing dreams in which the content and/or effect of the dream are related to the traumatic event(s). Children may experience frightening dreams but not remember their content.
• Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were happening in the now, with various degrees of dissociation. Children may show trauma-specific reenactment in play.
• Intense or prolonged distress when exposed to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
• Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

PTSD Criterion Cluster 3

The third criterion for a PTSD diagnosis involves at least one of the following symptoms:

• Avoidance of thoughts, feelings, or conversations associated with the event
• Avoidance of people, places, or activities that might cause remembrance of the event

PTSD Criterion Cluster 4

The fourth of the PTSD criteria involves persistent negative thoughts and changes in mood. At least two of the following must be present:

• Inability to remember an important aspect of the event(s)
• Persistent and exaggerated negative beliefs about oneself, others, or the world
• Persistent, distorted cognitions about the cause or consequences of the event(s)
• 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

PTSD Criterion Cluster 5

The fifth of the PTSD diagnosis criteria involves an increase in arousal and reactivity to include at least two of the following criteria:

• Irritable behavior and angry outbursts
• Reckless or self-destructive behavior
• Hypervigilance
• Exaggerated startle response
• Concentration problems
• Sleep disturbance

A Couple of Other Things About Diagnosing PTSD

Doctors must note the degree of dissociation (if any) and if PTSD onset is late by 6 months or more.

A mental health professional must diagnose PTSD before a person can receive treatment. You can start with your medical doctor or clinic. They are great for referrals, and sometimes their referral is required.

This information comes from the National Library of Medicine.