TRAUMA AND
STRESSOR
RELATED
DISORDERS
DR DEEPA D. AMARNATH
PAKAR PSIKIATRI
JABATAN PSIKIATRI DAN
KESIHATAN MENTAL
HOSPITAL KUALA LUMPUR
DSM 5 CRITERIA FOR POST TRAUMATIC
STRESS DISORDER
CRITERION A :
The person was exposed to: death, threatened
death, actual or threatened serious injury, or actual or
threatened sexual violence, as follows:
1. Direct exposure
2. 2. Witnessing, in person
3. Indirectly, by learning that a close relative or close friend was
exposed to trauma. If the event involved actual or threatened
death, it must have been violent or accidental.
4. Repeated or extreme indirect exposure to aversive details of
the event(s), usually in the course of professional duties
(e.g., first responders, collecting body parts; professionals repeat
edly exposed to details of child abuse). This does not include
indirect non-professional exposure through electronic media,
television, movies or pictures.
B. Intrusion symptoms
C. Persistent avoidance of stimuli associated with the
trauma
D. Negative alterations in cognitions and mood that are
associated with the traumatic event
E. Alterations in arousal and reactivity that are
associated with the traumatic event
CRITERION B :
1. Intrusion (1/5 symptoms needed)
Recurrent, involuntary and intrusive recollections
2. Traumatic nightmares
3. Dissociative reactions (e.g. flashbacks) which may occur o
a continuum from brief episodes to complete loss of
consciousness
4. Intense or prolonged distress after exposure to traumatic
reminders
5. Marked physiological reactivity after exposure to trauma-
related stimuli
CRITERION C :
Persistent effortful avoidance of distressing trauma-related stimuli
after the event (1/2 symptoms needed):
1. Trauma-related thoughts or feelings
2. Trauma-related external reminders (e.g. people, places,
conversations, activities, objects or situations)
CRITERION D.
Negative alterations in cognitions and mood that began or
worsened after the traumatic event (2/7 symptoms needed)
1. Inability to recall key features of the traumatic event
(usually dissociative amnesia; not due to head injury,
alcohol or drugs)
2. Persistent (& often distorted) negative beliefs and
expectations about oneself or the world (e.g. “I am bad,”
“the world is completely dangerous”)
3. Persistent distorted blame of self or others for causing the
traumatic event or for resulting consequences
4. Persistent negative trauma-related emotions (e.g. fear, horror,
anger, guilt, or shame)
5. Markedly diminished interest in (pre-traumatic) significant
activities
6. Feeling alienated from others (e.g. detachment or
estrangement)
7. Constricted affect: persistent inability to experience positive
emotions
CRITERION E
Trauma-related alterations in arousal and reactivity that began o
r worsened after the traumatic even (2/6 symptoms needed)
1. Irritable or aggressive behavior
2. Self-destructive or reckless behavior
3. Hypervigilance
4. Exaggerated startle response
5. Problems in concentration
6. Sleep disturbance
CRITERION F
Persistence of symptoms (in Criteria B, C, D and E) for more than
one month
CRITERION G
Significant symptom-related distress or functional impairment
CRITERION H
Not due to medication, substance or illness
DSM-5 CRITERIA FOR ACUTE
STRESS DISORDER
CRITERION A
PTSD A Criterion
CRITERION B. No mandatory (e.g., dissociative, etc.) symptoms
from any cluster
C. Nine (or more) of the following (with onset or exacerbation after t
he traumatic event):
• Intrusion
• Negative Mood
• Dissociative
• Avoidance
• Arousal
SUBSTANCE-RELATED
& ADDICTIVE
DISORDERS
DSM-5 CRITERIA FOR
SUBSTANCE USE DISORDERS
Source : Hasin DS, O'Brien CP, Auriacombe M, et al. DSM-5 criteria for substance use disorders: recommend
ations and rationale. Am J Psychiatry. 2013;170(8):834-851. doi:10.1176/appi.ajp.2013.12060782
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