What Are PTSD Symptoms? DSM-5 Criteria & How To Treat Them

Reviewed by Melinda (Santa) Gladden, LCSW

Published 12/28/2020

Post-traumatic stress disorder (PTSD) can be triggered by a variety of traumatic events; however, the general signs and symptoms of this disorder are consistent no matter the source of the stress. In this article, you will learn about posttraumatic stress disorder symptoms that people can display and how people can learn how to cope with them.

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What Is PTSD?

PTSD stands for post-traumatic stress disorder, a mental health condition that occurs when an individual faces a situation that traumatizes them.

In many cases, these events can be life-threatening, such as:

  • Being involved in combat or witnessing atrocities during a war
  • Being a victim or close to a terrorist attack
  • Being exposed to natural disasters
  • Being the victim of or witnessing violence, including domestic violence and sexual assault
  • Being involved in a serious accident or seeing someone be seriously injured or killed in one
  • Being attacked by an animal
  • Experiencing an illness

While PTSD is well-known by the public as a condition that can affect military personnel involved in combat, as you can see, the condition is much more than that and can happen due to a wide array of potential causes.

Because of this, post-traumatic stress disorder symptoms are also a lot more common than many people believe - it is estimated that one in 11 individuals will struggle with PTSD in their lifetimes. Each year, it affects over 3 percent of the United States population. [1]

Anyone can develop PTSD, and it can begin at a very early age; however, women are more likely to have the disorder than men are. Certain ethnic groups in the United States are also more prone to it, namely Latinos, African-Americans, and Native Americans. [1]

In general, PTSD symptoms can be group into four different categories, and within them, several different symptoms can persist:

  1. Intrusion symptoms
  2. Avoidance behaviors
  3. Changes in mood and cognitive ability
  4. Changes in arousal and reactivity

As you continue to read, you will learn more about these clusters and the symptoms that belong in them, and how they go into making a diagnosis by reading about the PTSD symptoms DSM-5 criteria.

DSM-5 Criteria For Posttraumatic Stress Disorder

Below you will find all of the information that goes into making a diagnosis for PTSD. [2]

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 events(s) as it occurred to others

Learning that the traumatic events(s) occurred to a close family member or close friend. In actual or threatened cases by the death of a family member or friend, the events(s) must have been violent or accidental.

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Experiencing repeated or extreme exposure to adverse details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to child abuse details).

This does not apply to exposure through electronic media, television, movies, or pictures unless this exposure is work-related."

  1. The presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s) occurred: Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).

In children older than 6, there may be frightening dreams without recognizable content. Recurrent distressing dreams in which the content and/or effect of the dream are related to the traumatic event(s).

Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the trauma event(s) were recurring. (Such reactions may occur on a continuum, with the extreme expression being a complete loss of awareness of present surroundings).

In children, trauma-specific reenactment may occur in play. Intense or prolonged psychological distress at 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)."

  1. 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. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

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).

  1. Negative alterations in cognitions and mood associated with the traumatic events(s), beginning or worsening after the traumatic event(s), as evidenced by two (or more) of the following: Inability to remember an important aspect of the traumatic events(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).

Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad," "no one can be trusted," "the world is completely dangerous," "my whole nervousness system is permanently ruined.").

Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) lead the individual to blame himself/herself or others—persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). Markedly diminished interest or participation in significant activities.

Feelings of detachment or estrangement from others. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

  1. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following.

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Irritable behavior and angry outbursts (with little or no provocation) are typically expressed as verbal or physical aggression toward people or objects. Reckless or self-destructive behavior Hypervigilance Exaggerated startle response Problems with concentration Sleep disturbances.

  1. Criteria B, C, D, and E last for more than 1 month.
  2. The disturbance causes clinically significant distress or impairment in social, occupational, or other important functioning areas. H. The disturbance is not attributable to a substance's effects (e.g., medication, alcohol) or another medical condition.

Specify whether:

With dissociative features

  • Depersonalization
  • Derealization

Specify if:

With delayed expression

This must be specified if the full criteria are not met until at least 6 months after the traumatic event; the criteria may be partially met during this time.

Treating PTSD

Despite being severe and impairing, post-traumatic stress disorder can be treated with professional help following a diagnosis with a PTSD symptoms checklist, like the criteria above.

For anyone who experiences trauma-related mental health disorders, not just PTSD, therapy will be an essential part of overcoming it, and variations of cognitive behavior therapy (CBT), a scientifically-proven methodology, are highly recommended.

For example, cognitive-processing therapy, prolonged exposure therapy, and stress inoculation therapy are all effective treatments derived from CBT. [1]

These types of treatments serve to help patients with PTSD identify the thoughts, feelings, and emotions that cause them distress and how they can learn how to cope with their triggers. Part of this involves confronting their memories and triggers, and it will be done gradually and safely with the guidance of a professional.

It will be entirely imagined in many cases since traumatic events cannot and should not be recreated, but it is still effective, and over time, patients can learn how to control their fear. However, it might be possible to confront certain triggers such as objects or smells, and people can become desensitized to them. This is known as in vivo exposure.

These strategies also teach individuals how to stop utilizing avoidance behaviors, strengthening the disorder, and making it persistent. Avoidance is also often an issue in anxiety disorders and obsessive-compulsive disorder. While it can provide comfort, relief, and reassurance that nothing harmful can happen, it also reinforces the fear. It can become more extreme as people develop a dependency on using avoidance as a tool to cope.

Therapy can be done individually, or it can be done in groups; both have their benefits, but many people have found group therapy to be comforting and an outlet to connect and relate to others who have similar experiences as them with their PTSD symptoms.

Medication may also be prescribed for PTSD symptoms, and it can make progressing through therapy much more manageable. Some can reduce anxiety symptoms and treat the sleep difficulties that people with PTSD struggle with.

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Do You Have PTSD?

If you show any of the signs or symptoms of PTSD, it is recommended that you speak to a doctor or mental health professional as soon as possible who can give you a formal diagnosis and help you start treatment.

PTSD does not go away on its own, and it typically gets worse over time. While many people might be hesitant to commit to therapy, especially exposure, it is important to gain control over your feelings and emotions and overcome it because it can seem frightening.

If you are still uncertain if you have PTSD, you can take this free test to find out before scheduling an appointment with a professional. It is quick and free, and it can help provide you with the answers you are looking for.

Conclusion

Treating PTSD will require a tremendous amount of effort and perseverance, but it is possible to regain control over your life through an effective treatment plan. With education and understanding of the symptoms and why PTSD persists, you are already on the right track to doing so.

References

  1. American Psychiatric Association. (2020, August). What Is Posttraumatic Stress Disorder? Retrieved from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd
  2. Traumadissociation.com. (2014, January 06). Posttraumatic stress disorder - symptoms and causes with DSM-5 criteria. Retrieved from http://traumadissociation.com/ptsd.html

NOTES: No changes needed.
 Does not go against what is clinically accepted.
 Does not encourage mindsets or practices that may be harmful to the reader.
 Is factual and up-to-date.