PTSD Diagnosis DSM-5 PTSD Diagnostic Criteria By Matthew Tull, PhD twitter Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our editorial process Matthew Tull, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on November 07, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Review Board Steven Gans, MD on November 07, 2019 Print PeopleImages / E+ / Getty Images The criteria for diagnosing post-traumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are somewhat different than the criteria in the fourth edition. Here are the symptom criteria in the DSM-5. Symptoms of PTSD The following are the formal diagnostic criteria that need to be met in order to be diagnosed with PTSD. Criterion A You were exposed to one or more event(s) that involved death or threatened death, actual or threatened serious injury, or threatened sexual violation. In addition, these events were experienced in one or more of the following ways: Directly experiencing the eventWitnessing the event as it occurred to someone elseYou learned about an event where a close relative or friend experienced an actual or threatened violent or accidental deathExperiencing repeated exposure to distressing details of an event, such as a police officer repeatedly hearing details about child sexual abuse How Traumatic Events Cause PTSD Criterion B You experience at least one of the following intrusive symptoms associated with the traumatic event: Unexpected or expected reoccurring, involuntary, and intrusive upsetting memories of the traumatic eventRepeated upsetting dreams where the content of the dreams is related to the traumatic eventThe experience of some type of dissociation (for example, flashbacks) where you feel as though the traumatic event is happening againStrong and persistent distress upon exposure to cues that are either inside or outside of your body that is connected to your traumatic eventStrong bodily reactions (for example, increased heart rate) upon exposure to a reminder of the traumatic event Definition of Dissociation for People With PTSD Criterion C Frequent avoidance of reminders associated with the traumatic event, as demonstrated by one of the following: Avoidance of thoughts, feelings, or physical sensations that bring up memories of the traumatic eventAvoidance of people, places, conversations, activities, objects, or situations that bring up memories of the traumatic event How to Anticipate and Manage PTSD Intrusive Thoughts Criterion D At least two of the following negative changes in thoughts and mood that occurred or worsened following the experience of the traumatic event: Inability to remember an important aspect of the traumatic eventPersistent and elevated negative evaluations about yourself, others, or the world (for example, "I am unlovable," or "The world is an evil place")Elevated self-blame or blame of others about the cause or consequence of a traumatic eventA negative emotional state (for example, shame, anger, or fear) that is pervasiveLoss of interest in activities that you used to enjoyFeeling detached from othersPersistent inability to experience positive emotions (for example, happiness, love, joy) The Relationship Between PTSD and Depression Criterion E At least two of the following changes in arousal that started or worsened following the experience of a traumatic event: Difficulty concentratingFeeling constantly "on guard" or like danger is lurking around every corner (or hypervigilance)Heightened startle responseImpulsive or self-destructive behaviorIrritability or aggressive behaviorProblems sleeping Hypervigilance as a Symptom of PTSD Criterion F The above symptoms last for more than one month. Criterion G The symptoms bring about considerable distress and/or interfere greatly with a number of different areas of your life. Criterion H The symptoms are not due to a medical condition or some form of substance use. DSM-5 PTSD Diagnosis In order to be diagnosed with PTSD according to the DSM-5, you need to meet the following:Criterion AOne symptom (or more) from Criterion BOne symptom (or more) from Criterion CTwo symptoms (or more) from Criterion DTwo symptoms (or more) from Criterion ECriteria F through H Changes in DSM-5 The biggest change in the DSM-5 is removing PTSD from the category of anxiety disorders and putting it in a classification called "Trauma- and Stressor-Related Disorders." Other key changes include: More clearly defining what kind of events are considered traumatic in Criterion AAdding different types of exposure in Criterion AIncreasing the number of symptom groups from three to four by separating avoidance symptoms into their own group (Criterion C)Changing the wording of some of the symptomsAdding a new set of criteria for children aged 6 or youngerEliminating the "acute" and "chronic" phasesIntroducing a new specifier called "dissociative features" You can review the rationale behind these changes, as well as look at other changes in the DSM-5, at the website for the American Psychiatric Association (APA). An Overview of PTSD Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Center for Substance Abuse Treatment (US). Exhibit 1.3-4, DSM-5 Diagnostic Criteria for PTSD - Trauma-Informed Care in Behavioral Health Services - NCBI Bookshelf. Trauma-Informed Care in Behavioral Health Services. Published 2014. Choi KR, Seng JS, Briggs EC, et al. The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms. J Am Acad Child Adolesc Psychiatry. 2017;56(12):1062-1072. 10.1016/j.jaac.2017.09.425 Sareen J. Posttraumatic stress disorder in adults: impact, comorbidity, risk factors, and treatment. Can J Psychiatry. 2014;59(9):460–467. doi:10.1177/070674371405900902 Contractor AA, Weiss NH, Dranger P, Ruggero C, Armour C. PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology. Psychiatry Res. 2017;252:215–222. doi:10.1016/j.psychres.2017.03.008 Additional Reading American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC: 2013. Friedman MJ, Resick PA, Bryant RA, Brewin CR. Considering PTSD for DSM-5. Depression and Anxiety. September 2011;28(9):750-769. doi:10.1002/da.20767. Pai A, Suris AM, North CS. Posttraumatic Stress Disorder in the DSM-5: Controversy, Change, and Conceptual Considerations. Hunter SJ, ed. Behavioral Sciences. 2017;7(1):7. doi:10.3390/bs7010007.