First and foremost, an individual must have been exposed to an actual or threatened death, serious injury, or sexual violence in one or more of the following ways:
• Directly experiencing the traumatic event
• Witnessing, in person, the event as it occurred to others
• Learning that a traumatic violent or accidental event occurred to a close family member or close friend
• Experiencing repeated or extreme exposure to aversive details of traumatic events (e.g., trauma details that police or other emergency first responders witness)
Second, an individual experiences at least one or more "intrusion symptoms" associated with the traumatic event. Such symptoms may include:
• Recurrent, involuntary intrusive memories of the event
• Recurrent distressing traumatic dream content
• Re-experiencing the traumatic event, or "flashback"
• Intense distress as a result of internal or external cues that symbolize or resemble the traumatic event
• Strong physical reactions to internal or external cues that symbolize or resemble the traumatic event
Third, an individual experiences at least one symptom involving persistent avoidance of internal and external reminders and experiences associated with the traumatic
event, such as memories, thoughts, and feelings, or certain people, places, activities, objects, or situations that arouse distressing memories, thoughts, or feelings associated
with the traumatic event.
Fourth, an individual experiences at least two negative changes in cognition (thinking processes) and feelings, such as:
• Inability to remember important aspects of the traumatic event
• Exaggerated negative beliefs or expectations about oneself, others, or the world
• Persistent, distorted thoughts or beliefs about the cause or consequences of the traumatic event
• Persistent negative emotional states (e.g., fear, anger, guilt, shame)
• Very diminished interest or participation in significant activities
• Feelings of detachment or estrangement from others
• Persistent inability to experience positive emotions
Fifth, an individual will experience at least two symptoms involving marked alterations in arousal and reactivity associated with the traumatic event, such as:
• Irritable behavior or angry outbursts
• Reckless or self-destructive behavior
• Hypervigilance, or being always "on the lookout"
• Exaggerated startle response, such as when hearing a loud noise or if surprised
• Concentration problems
• Sleep Problems, such as difficulty falling asleep or staying asleep
Sometimes symptoms of PTSD are not recognized as such for years following the traumatic event. Memories of the traumatic event may be triggered later by another trauma or by other stressful events.
Even if you do not meet all criteria for PTSD, your symptoms may be quite distressing or interfere significantly in your ability to carry on with your normal life activities effectively. If you have been unable to deal well with such symptoms yourself or have difficulty resuming your desired lifestyle, psychotherapy may be quite beneficial. In particular, cognitive-behavioral, exposure-based, and mindfulness-based therapeutic approaches have research support as effective ways to reduce PTSD symptoms and to help resume a more satisfying level of life activities.