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The person has been exposed to a traumatic event in which both of the following were present:
- (1) 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 or others.
- (2) The person’s response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.
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The traumatic event is persistently re-experienced in one (or more) of the following ways:
- (3) Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
- (4) Recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.
- (5) Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience; illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
- (6) Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
- (7) Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
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Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
- (8) Efforts to avoid thoughts, feelings, or conversations associated with the trauma
- (9) Efforts to avoid activities, places, or people that arouse recollections of the trauma
- (10) Inability to recall an important aspect of the trauma
- (11) Markedly diminished interest or participation in significant activities
- (12) Feeling of detachment or estrangement from others
- (13) Restricted range of affect (e.g., unable to have loving feelings)
- (14) Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal lifespan)
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D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
- (1) Difficulty falling or staying asleep
- (2) Irritability or outbursts of anger
- (3) Difficulty concentrating
- (4) Hyper-vigilance
- (5) Exaggerated startle response
- Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month.
- The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more
Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor.
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