PTSD Flashcards
The clinical picture of PTSD is characterised by four core symptom groups:
1) intrusion (genoplevelse)
2) active avoidance (undgåelse)
3) negative alterations in cognitions and mood (negative ændringer I kognition og stemningsleje) (known in the DSM-IV as passive avoidance/emotional numbing)
4) hyperarousal (øget alarmberedskab)
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria A:
Exposure to actual or threatened death, serious injury, or sexual violence
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria A (continued): 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, in person, the event occurring to others
- Learning that a close relative or close friend was exposed to violent or accidental trauma
- Repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains, professionals repeatedly exposed to details of child abuse, but not exposure through electronic media unless this is work related)
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria B: Presence of one or more of the following intrusion symptoms associated with the traumatic event(s):
- Recurrent, involuntary, intrusive distressing memories of the traumatic event
- Recurrent distressing dreams related to the event
- Dissociative reactions (e.g., flashbacks) in which the person feels or acts as if the event were recurring
- Intense or prolonged psychological distress after exposure 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)
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria C:
Persistent avoidance of stimuli associated with the traumatic event(s)
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria C (continued): Persistent avoidance of stimuli associated with the traumatic event(s) s evidenced by one or both of the following:
- Avoidance of, or efforts to avoid distressing memories, thoughts, or feelings associated with the trauma
- Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts or feelings related to the trauma
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria D:
Negative alterations in cognitions and mood associated with the trauma
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria D (continued):
Negative alterations in cognitions and mood associated with the trauma as evidenced by two of the following:
- Inability to recall an important aspect of the trauma (typically due to dissociative amnesia and not due to other factors such as head injury, alcohol or drugs)
- Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world
- Persistent, distorted cognitions about the cause or consequences of the event leading to blame of self/others
- Persistent negative emotional state (e.g., fear, horror, anger, guilt, shame)
- Markedly diminished interest or participation in significant activities
- Feelings of detachment or estrangement from others
- Persistent inability to experience positive emotions
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria E:
Marked alterations in arousal and reactivity associated with the event
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria E (continued): Marked alterations in arousal and reactivity associated with the event as evidenced by two or more of the following:
- Irritable behaviour or angry outbursts
- Reckless or self destructive behaviour
- Hypervigilance
- Exaggerated startle response
- Problems with concentration
- Sleep disturbance
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria F:
Duration of disturbance longer than 1 month
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria G:
Causes clinically significant distress and impairment in functioning.
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Criteria H:
Not attributable to the physiological effects of a substance or another medical condition.
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the DSM-5
Specify subtype:
With dissociative symptoms either
depersonalization or derealization.
With delayed expression, if full criteria are
not met until after 6 months.
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the ICD-10
Criteria A:
Exposure to a stressful event or situation (either short or long lasting) of exceptionally threatening or catastrophic nature, which is likely to cause pervasive distress in almost anyone.
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the ICD-10
Criteria B:
Persistent remembering or “reliving”
the stressor by intrusive flash backs,
vivid memories, recurring dreams, or by experiencing distress when exposed to circumstances resembling or associated with the stressor.
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the ICD-10
Criteria C:
Actual or preferred avoidance of circumstances resembling or associated with the stressor (not present before exposure to the stressor).
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the ICD-10
Criteria D: Either (1) or (2):
(1) Inability to recall, either partially or completely, some important aspects of the period of exposure to the stressor
(2) Persistent symptoms of increased psychological sensitivity and arousal (not present before exposure to the stressor) shown by any two of the following:
a) difficulty in falling or staying asleep;
b) irritability or outbursts of anger;
c) difficulty in concentrating;
d) hyper-vigilance;
e) exaggerated startle response.
Diagnostic criteria for post-traumatic stress disorder (PTSD) according to the ICD-10
Criteria E:
Criteria B, C and D all occurred within six months of the stressful event, or the end of a period of stress.
What is acute stress disorder (ASD)? (DSM-5)
Describes a post-trauma reaction that has been present for more than 3 days but less than the 4 weeks required for a PTSD diagnosis. ASD criteria require the same Criterion A as PTSD, with at least nine symptoms from a list of 14 intrusion, negative mood, dissociative, avoidance and arousal symptoms.
What is “complex PTSD” or “complicated PTSD”?
Enduring maladaptive effects on personality following sustained and severe trauma. While the proposed new diagnostic category was not included in either DSM-IV or DSM-5, ICD-10 includes a similar diagnostic category of “enduring personality change after catastrophic experience.”
How many people with PTSD meet criteria for at least one other psychiatric diagnosis (comorbidity)?
80%–85%
Recent epidemiological studies indicate that the experience of trauma is relatively common, with around ___% of the general population having experienced a Criterion A1 event
60%
Estimates of lifetime PTSD prevalence within the general community tend to cluster around ___% for women
10%
