Today, the accepted criteria for a diagnosis of PTSD are:
A. The person
has been exposed to a traumatic event in which both of the following have been
The person has experienced, witnessed, or been confronted
with an event or events that involve actual or threatened death or serious
injury, or a threat to the physical integrity of oneself or others.
response involved intense fear, helplessness or horror. Note:
in children, it may be expressed instead by disorganized or agitated behavior.
B. The traumatic event is persistently re-experienced in at least one of the
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
Recurrent distressing dreams of the event. Note: in
children, there may be frightening dreams without recognizable content.
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 upon awakening or when intoxicated). Note:
in children, trauma-specific reenactment may occur.
distress at exposure to internal or external cues that symbolize or resemble
an aspect of the traumatic event.
Physiologic reactivity upon exposure to
internal or external cues that symbolize or resemble an aspect of the traumatic
avoidance of stimuli associated with the trauma and numbing of general responsiveness
(not present before the trauma), as indicated by at least three of the following:
to avoid thoughts, feelings or conversations associated with the trauma.
to avoid activities, places or people that arouse recollections of the trauma.
to recall an important aspect of the trauma.
Markedly diminished interest
or participation in significant activities.
Feelings of detachment or estrangement
Restricted range of affect (e.g., unable to have loving feelings).
of foreshortened future (e.g., does not expect to have a career, marriage,
children or a normal life span).
D. Persistent symptoms of increased
arousal (not present before the trauma), indicated by at least two of the following:
falling or staying asleep.
Irritability or outbursts of anger.
Exaggerated startle response
E. Duration of the disturbance
(symptoms in B, C, and D) is more than one month.
F. The disturbance causes
clinically significant distress or impairment in social, occupational or other
important areas of functioning.
The veterans featured in Soldier’sHeart exhibit a
wide array of the symptoms of posttraumatic stress disorder. As you walk
with them through their life experiences, PTSD will become more than a sterile
enumeration of causes and symptoms and will change forever the way you view
this debilitating disorder.