has been exposed to a traumatic event in which both of the following
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 self
The person's response involved intense fear, helplessness, or
experiencing or after experiencing the distressing event, the
individual has three (or more) of the following dissociative symptoms:
sense of numbing, detachment, or absence of emotional
A reduction in awareness of his or her surroundings (e.g., "being
in a daze").
Depersonalization - dissociative amnesia (i.e., inability to
recall an important aspect of the
The patient persistently re-experienced the traumatic event in
at least one or
more of the following ways: recurrent images,
thoughts, dreams, illusions,
flashback episodes, or a sense of reliving
the experience; or distress on exposure
to reminders of the traumatic event.
Marked avoidance of stimuli that arouse recollections of the trauma
feelings, conversations, activities, places,
There are marked symptoms of anxiety or increased arousal (e.g.,
sleeping, irritability, poor concentration, hypervigilance,
response, motor restlessness).
At least 1of the following applies:
feels marked distress from the symptoms.
They interfere with usual social, job or personal functioning.
They block the patient from doing something important such as
getting legal or medical help or telling family or other supporters
about the experience.
The disturbance lasts for a minimum of 2 days and a maximum of
and occurs within 4 weeks of the traumatic event.
The disturbance is not due to the direct physiological effects
of a substance
(e.g., a drug of abuse, a medication) or a general
medical condition, is not
better accounted for by Brief
Psychotic Disorder, and is not merely an
exacerbation of a preexisting mental disorder.
may occur and are more commonly seen in association with an interpersonal
stressors such as childhood sexual or physical abuse, domestic
violence, impaired affect, self-destructive and impulsive behavior,
dissociative symptoms, somatic complaints or a change from the
individual’s previous personality characteristics.
Some disorders display similar or sometimes even the same symptom.
The clinician, therefore, in his diagnostic attempt has to differentiate
against the following disorders which one needs to be ruled out
to establish a precise diagnosis.
Disorder Due to a General Medical Condition;
Brief Psychotic Disorder;
Major Depressive Episode;
When an individual
who has been exposed to a traumatic event develops anxiety symptoms,
re-experiencing of the event, and avoidance of related stimuli
lasting less than four weeks they may develop acute stress disorder.
and Psychotherapy [ See
Therapy Section ]:
Anxiety disorders are responsive to counseling and to
a wide variety of psychotherapies. More severe and persistent
symptoms also may require pharmacotherapy.
include focused, time-limited therapies that address ways of coping
with anxiety symptoms more directly rather than exploring unconscious
conflicts or other personal vulnerabilities These therapies
typically emphasize cognitive and behavioral assessments.
It is possible
that more traditional forms of therapy based on psychodynamic
or interpersonal theories of anxiety also may be used However,
these therapies have not yet received extensive empirical support
[ See Psychopharmacology
Section ] :
of Psychotherapy and Pharmacotherapy:
Some patients with this disorder may benefit from both psychotherapy
and pharmacotherapy treatment modalities, either combined or used