PTSD in the DSM-IV

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Specifiers for PTSD?

1. Acute: Symptom duration is less than 3 months. 2. Chronic: Symptom duration is more than 3 months. 3. With Delayed Onset: at least 6 mos have passed between the traumatic event and the onset of the symptoms.

Lifetime Prevalence in US adults

8%

What percentage experience complete recovery within three months?

50%

Most important factors affecting the likelihood of developing PTSD?

Severity, duration, and proximity of an individual's exposure to the traumatic event.

What distinguishes PTSD from an Adustment Disorder?

In PTSD, the stressor must be of an extreme nature. OR, if the stressor is extreme yet the response doesn't meet criteria for PTSD.

What distinguishes PTSD from Acute Stress Disorder?

The symptom pattern must occur within 4 weeks of the traumatic event AND resolve within that same 4-week period.

A history of what psychiatic disorder in a first-degree relative has been related to an increased vulnerability to developing PTSD?

Depression

How many criteria define PTSD?

Six: A, B, C, D, E, F

What is criterion A for PTSD?

The person has been exposed to a traumatic event in which BOTH of the following were present.

What factors MUST be present for the traumatic event which ultimately precipitates the symptoms of PTSD?

1. the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of others. AND. 2. the person's response involved intense fear, helplessness, or horror.

How can the criterion A differ in children?

Intense fear, helplessness, or horror may be expressed instead by disorganized or agitated behavior.

What is criterion B for PTSD?

The traumatic event is persistently REEXPERIENCED in ONE (or more) of the following ways.

How many symptoms of REEXPERIENCING are there?

FIve

What are the five symptoms of reexperiencing in PTSD?

1. Recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions. 2. Recurrent distressing dreams of the event. 3. Acting or feeling as if the traumatic event were recurring (includes a sense of reliving, illusions, hallucinations, and dissociative flashback episodes including those that occur on awakening or when intoxicated. 4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. 5. physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

How can criterion B differ for children?#

#1 can be replaced with repetitive play in which themes or aspects of the trauma are expressed. #2 can be replaced with frightening dreams without recognizable content. #3 can be replaced with trauma-specific reenactment.

What is criterion C of PTSD?

Persistent AVOIDANCE of stimuli associated with the trauma and NUMBING of general responsiveness (not present before the trauma), as indicated by THREE (or more) of the following:

How many symptoms comprise criterion C?

Seven

What are the seven symptoms of criterion C?

1. efforts to avoid thoughts, feelings, or conversations associated with the trauma. 2. efforts to avoid activities, places, or people that arouse recollections of the trauma. 3. inability to recall an important aspect of the trauma. 4. markedly diminished interest or participation in significant activities. 5. feeling of detachment or estrangement from others. 6. restricted range of affect (eg, unable to have loving feelings) 7. sense of a foreshortened future (eg, does not expect to have a career, marriage, children, or a normal life-span)

What is criterion D for PTSD?

What is criterion D for PTSD?Persistent symptoms of INCREASED AROUSAL (not present before the trauma), as indicated by TWO (or more) of the following:

How many symptoms comprise criterion D?

Five

What are the five symptoms of criterion D?

1. difficulty falling or staying asleep. 2. irritability or outbursts of anger. 3. difficulty concentrating. 4. hypervigilance. 5. exaggerated startle response

What is criterion E for PTSD?

Duration of the disturbance is more than 1 month.

What is criterion F for PTSD?

Causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

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