PTSD Test: The Requirements for a Diagnosis

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Post-traumatic stress disorder (PTSD) occurs after a traumatic event and interferes with a person's ability to function. You may wonder if you or someone you care about has PTSD, and whether you need to get professional help. If you are experiencing symptoms of PTSD, it is important to see a doctor so that you can get the right diagnosis and treatment.

The Difference Between PTSD and Stress

Not everyone who has experienced a traumatic event also has PTSD. After a traumatic event, it is normal to have strong feelings of anxiety, sadness, or stress. Some people may even experience nightmares, memories about the event, or problems sleeping at night, which are common characteristics of PTSD.

However, these symptoms do not necessarily mean that you have PTSD. Think of it this way: Headaches can be a symptom of a bigger problem, such as meningitis. However, having a headache does not necessarily mean that you have meningitis. The same is true for PTSD. Many of the symptoms are part of the body's normal response to stress, but having them does not mean that you have PTSD.

There are specific requirements that must be met for a diagnosis of PTSD. These requirements are outlined in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

DSM-5 Criteria for PTSD

Criterion A: Stressor

Exposure or threat of death, serious injury, or sexual violence in one or more of the following ways:

  1. You directly experienced the event.
  2. You witnessed the event happen to someone else, in person.
  3. You learned of a close relative or close friend who experienced an actual or threatened accidental or violent death.
  4. You had repeated indirect exposure to distressing details of the event(s). This could occur in the course of professional duties (first responders, collecting body parts, or professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or pictures.

Criterion B: Intrusion Symptoms

The traumatic event is persistently re-experienced in one or more of the following ways:

  • Recurrent, involuntary, and intrusive memories. Children older than six may express this symptom through repetitive play.
  • Traumatic nightmares or upsetting dreams with content related to the event. Children may have frightening dreams without content related to the trauma.
  • Dissociative reactions, such as flashbacks, in which it feels like the experience is happening again. These may occur on a continuum ranging from brief episodes to complete loss of consciousness.
  • Intense or prolonged distress after exposure to traumatic reminders.
  • Marked physiologic reactivity, such as increased heart rate, after exposure to traumatic reminders.

Criterion C: Avoidance

Persistent effortful avoidance of distressing trauma-related reminders after the event as evidenced by one or both of the following:

  • Avoidance of trauma-related thoughts or feelings.
  • Avoidance of trauma-related external reminders, such as people, places, conversations, activities, objects, or situations.

Criterion D: Negative Alterations in Mood

Negative alterations in cognitions and mood that began or worsened after the traumatic event as evidenced by two or more of the following:

  • Inability to recall key features of the traumatic event. This is usually dissociative amnesia, not due to head injury, alcohol, or drugs.
  • Persistent, and often distorted negative beliefs and expectations about oneself or the world, such as "I am bad," or "The world is completely dangerous".
  • Persistent distorted blame of self or others for causing the traumatic event or for the resulting consequences.
  • Persistent negative emotions, including fear, horror, anger, guilt, or shame.
  • Markedly diminished interest in activities that used to be enjoyable.
  • Feeling alienated, detached or estranged from others.
  • Persistent inability to experience positive emotions, such as happiness, love, and joy.

Criterion E: Alterations in Arousal and Reactivity

Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event, including two or more of the following:

  1. Irritable or aggressive behavior
  2. Self-destructive or reckless behavior
  3. Feeling constantly "on guard" or like danger is lurking around every corner (hypervigilance)
  4. Exaggerated startle response
  5. Problems in concentration
  6. Sleep disturbance

Criterion F: Duration

Persistence of symptoms in Criteria B, C, D, and E for more than one month.

Criterion G: Functional Significance

Significant symptom-related distress or impairment of different areas of life, such as social or occupational.

Criterion H: Exclusion

The disturbance is not due to medication, substance use, or other illness.

DSM-5 PTSD Diagnosis

In order to be diagnosed with PTSD according to the DSM-5, you need to meet the following:

  • Criterion A
  • One symptom or more from Criterion B
  • One symptom or more from Criterion C
  • Three symptoms or more from Criterion D
  • Three symptoms or more from Criterion E
  • Criteria F through H

DSM-5 Changes in PTSD diagnosis

There are a few changes in the latest version of the DSM regarding PTSD diagnosis. 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 A
  • Adding a fourth type of exposure in Criterion A
  • Increasing the number of symptom groups from three to four by separating avoidance symptoms into their own group (Criterion C)
  • Increasing the number of symptoms from 17 to 20
  • Changing the wording of some of the symptoms from DSM-IV
  • Adding a new set of criteria for children aged 6 or younger
  • Eliminating the "acute" and "chronic" specifiers
  • Introducing a new specifier called "dissociative features"

A Word From Verywell

In addition to PTSD, your doctor may also ask you about other psychological conditions, including major depressionsubstance use disorderseating disorders, or anxiety disorders.

PTSD is a difficult illness to cope with. Yet, there is hope. We are learning more and more about PTSD everyday, and a number of treatment options are available. 

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Article Sources
  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.