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The person has been exposed to a traumatic event in which both of
the following were present:
- 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
- the person's response involved intense fear, helplessness, or
horror. Note: In children, this may be expressed instead by
disorganized or agitated behavior
The traumatic event is persistently reexperienced in one (or
more) of the following ways:
- 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.
- recurrent distressing dreams of the event. Note: In children,
there may be frightening dreams without recognizable content.
- 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.
- intense psychological distress at exposure to internal or
external cues that symbolize or resemble an aspect of the
traumatic event
- physiological reactivity on exposure to internal or external
cues that symbolize or resemble an aspect of the traumatic event
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:
- efforts to avoid thoughts, feelings, or conversations
associated with the trauma
- efforts to avoid activities, places, or people that arouse
recollections of the trauma
- inability to recall an important aspect of the trauma
- markedly diminished interest or participation in significant
activities
- feeling of detachment or estrangement from others
- restricted range of affect (e.g., unable to have loving
feelings)
- sense of a foreshortened future (e.g., does not expect to have
a career, marriage, children, or a normal life span)
Persistent symptoms of increased arousal (not present before the
trauma), as indicated by two (or more) of the following:
- difficulty falling or staying asleep
- irritability or outbursts of anger
- difficulty concentrating
- hypervigilance
- 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.
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