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Healing Voices

Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) may develop in response to an extreme stressor that is outside
the usual course of life events. Fortunately, due to the presence of inherent resilience or the presence
of protective factors, not everyone who is exposed to traumatic events develops PTSD.

In addition to exposure to a traumatic stressor, a person diagnosed with PTSD also develops a
constellation of other symptoms, namely those related to re-experiencing the trauma in some way
(intrusion), avoidance, negative cognitions and mood, and arousal and reactivity. The full criteria
for PTSD are found below.

DSM-5 Criteria for Post-traumatic Stress Disorder (PTSD)

Note: The following criteria apply to adults, adolescents, and children older than 6 years.
A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others.
3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual
or threatened death of a family member or friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders
collecting human remains; police officers repeatedly exposed to details of child abuse).
Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures,
unless this exposure is work related.
B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning
after the traumatic event(s) occurred:
1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note: In children older
than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic
event(s). Note: In children, there may be frightening dreams without recognizable content.
3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were
recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete
loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in
play.
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or
resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the
traumatic event(s).
C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s)
occurred, as evidenced by one or both of the following:
1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated
with the traumatic event(s).
2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects,
situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the
traumatic event(s).

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