Monday, January 17, 2011

PTSD - DSM-IV Criteria

The DSM-IV Criteria for Post Traumatic Stress Disorder (PTSD) are:
A. The person has been exposed to traumatic event, in which both of the following were present:
  1. The person experienced, witnessed, or was confronted with an event(s) that involved actual or threatened death or serious injury, or threat to physical integrity of self or others
  2. The response involved intense fear, helplessness, or horror.  (In children, may be expressed as disorganized/agitated behavior)
B. Traumatic event re-experienced in one (or more) of following ways:
  1. recurrent and intrusive distressing recollections of the event, including images, thoughts, and perceptions (repetitive play in children)
  2. recurrent distressing dreams of event (in children may be frightening without recognizable content)
  3. acting or feeling as though the event were recurring (reliving the experience, illusions, hallucinations, dissociative flashbacks) (In children, trauma specifc re-enactment)
  4. intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
  5. physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
C. 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:
  1. efforts to avoid thoughts, feelings, or conversations associated with the trauma
  2. efforts to avoid activities, places, or people that arouse recollection of the trauma
  3. inability to recall an important aspect of the trauma
  4. markedly diminished interest or participation in significant activities
  5. feeling of detachment or estrangement from others
  6. restricted range of affect (e.g. unable to have loving feelings)
  7. sense of foreshortened future (e.g. does not expect to have career, marriage, children or normal life span)
D. Persistent symptoms of increased arousal (not present before trauma) as indicated by two or more of the following:
  1. difficulty falling asleep or staying asleep
  2. irritability or outbursts of anger
  3. difficulty concentrating
  4. hypervigilance
  5. exaggerated startle response
E. Duration of disturbance is > 1 month
F. Disturbance causes clinically significant distress/impairment in social, occupational, or other important areas of functioning.

Specifiers for PTSD

Acute: < 3 months
Chronic: > 3 months
With delayed onset: onset of symptoms > 6 months after stressor

Post Traumatic Stress Disorder (PTSD) - Mnemonic

A useful mnemonic for Post Traumatic Stress Disorder is TRAUMA
 
T - Traumatic event exposure
R - Re-experience (1+)
A - Avoidance (3+)
U - Unable to function
M - Month or more of symptoms
A - Arousal increased (2+)

Social Anxiety Disorder - Mnemonic

A useful mnemonic for Social Anxiety Disorder is FAAIINT
F - fear of one or more social or performance situations in which person may feel scrutinized, humiliated, or embarrassed
A - Anxiety when exposed
A - Avoidance of situation
I - Insight into unreasonableness
I - Interference with daily routine
N - Not due to general medical condition, substance, or medication.  If GMC present, the fear is unrelated to it.
T - Timing - in individuals <18, longer than six months