What Are The PTSD Criteria For Diagnosis?
Updated August 28, 2020
Medically Reviewed By: Traci Ball, LLC
The unfortunate truth is that far too many people are suffering from PTSD around the world, and it's not what many people think it is. For the longest time, PTSD was thought of as something that only people who had been in the military suffered from. It was considered related only to having been in a combat zone. But over time, we've come to realize that isn't true. People can get PTSD from a variety of different negative situations in their lives. When it comes to diagnosis, there are specific things that professionals look for.
When it comes to forming a diagnosis, there are eight categories that are required before an individual can be diagnosed. These refer to specific types of behavior, feelings, and length of the experience. Without each of these being present, a diagnosis may be made for another type of mental health disorder or different problem not considered to be PTSD. Let's take a look at what is involved when diagnosing PTSD.
The first category requires that the individual experience one of the following situations. They must have been exposed to actual or threatened death, injury, or sexual violence. This exposure must have occurred as a result of them being either directly exposed (it happened to them), witnessing trauma, or learning that a close relative or loved one was a victim of trauma. One of these must be present for diagnosis.
Next, the individual must have persistent experiences of the event in at least one of the following ways: through upsetting memories, flashbacks, emotional distress when recalling the incident, or a physical reaction in response to triggers or nightmares. Without the aspect of reliving the event in some form or another, in an adverse way, a diagnosis is not made for PTSD.
The individual must exhibit the avoidance of trauma-related triggers and events after the trauma has occurred. This may include the evasion of thoughts, feelings, or different reminders. These behaviors must be present.
In this category, the individual must experience at least two of the different criteria to be diagnosed with PTSD or to continue along the process towards possible diagnosis. They must have negative thoughts or feelings that started or became worse after the trauma. Those must have changed based on the inability to recall specific aspects of the event, overtly negative thoughts about themselves, negative affect, decreased interest in normal activities, feelings of isolation, and exaggerated self-blaming for the trauma that occurred.
In this category also, the individual must be experiencing at least two of the criteria to be considered for a diagnosis of PTSD. They must have some form of arousal or reaction that started or became worse after the trauma. This could include risky and destructive behavior, hypervigilance, heightened startle reflex, trouble sleeping, difficulty concentrating, or irritability, and aggression. These feelings must be different from those that may have been felt or suffered prior to the trauma.
For these three criteria, the individual must have symptoms that have lasted for more than a month. They may create a level of distress or functional impairment, and they must not be related to any form of medication, substance use or illness. All three of these criteria must be met in addition to the ones already discussed previously for a diagnosis of PTSD. It is important to note that even if all of these criteria are present, there is still an element of individuality to each person and each diagnosis. However, it is possible that the criteria would be met, and the doctor does not make a diagnosis of PTSD.
Types of PTSD
Once a diagnosis is made or believed to be accurate, there are two different types of PTSD that someone could be afflicted with. These are dissociative specification and delayed specification. The two versions are slightly different in how they affect an individual. They may have the same or similar methods of treatment, although the doctor may need to focus on specific situations and difficulties that the individual is experiencing.
Dissociative specification means that the individual experiences all the required criteria that were discussed above, but also experiences either depersonalization or derealization. These emotions must be considered severe and relate to the person feeling either detached or as though the events that are occurring around them are not real or happening at a distance.
Delayed specification means that the criteria do not present until approximately six months or more after the trauma. In this situation, the individual may start to feel some of the emotions and symptoms immediately, but full onset takes a longer period to develop fully. The individual may not be able to receive a diagnosis until at least six months after the event.
When it comes to treating PTSD, treatment generally includes cognitive processing as well as prolonged exposure therapy. There may be other aspects of therapy including eye movement desensitization, reprocessing, stress inoculation training, and medications. Each of these, when used in different combinations and quantities, can help an individual who is suffering from PTSD. They can start working through their experience to overcome trauma and begin to work through the symptoms and side effects that have kept them from being able to participate in daily life.
Cognitive processing is generally a process that involves talking to a therapist about the events that occurred and the resulting trauma. The individual is generally required to talk about the trauma itself, how it affected them, and the details and emotions of the event that they are still experiencing. The therapist helps with the process of understanding the facts of the event and the individual's perception of it to improve and change the way that it occurs within their mind.
Exposure therapy is an alternative to this or is used in conjunction with it. In this form of therapy, the events or situations that you may have been avoiding as a result of the trauma are discussed in a safe environment. This process is designed to help separate those things from the trauma itself so that you can move on with your life without having to avoid situations, people, events, or objects.
Eye movement desensitization is another way that you can work on overcoming the symptoms and feelings associated with PTSD. With this method of healing, you won't have to talk about the event. Instead, you are tasked with thinking about and re-experiencing the event in your mind while you watch something play out on a screen in front of you. It might be a flashing light, a slight movement, or a repeating sound. The idea is to reprogram your mind to better deal with the negative feelings of the event.
Stress inoculation training is another way of attempting to overcome the trauma without actually having to talk about it. Instead of working through the specific trauma, you learn new ways to work on your stress response and react appropriately to negative events or emotions. This type of therapy teaches you things like breathing techniques and massage. You'll also learn how to navigate negative thoughts when they occur.
Finally, medication can be used in conjunction with any of these types of therapy. Because of the way that your brain reacts to trauma, and the differences between individuals, it's difficult to determine for sure what type of therapy will work when beginning the process of working through trauma. Medications can help to improve some of the symptoms while you're working on things in other ways.
Getting the Help You Need
If you're ready to get the help that you need to overcome PTSD, then find a therapist who is going to be there to help you with every step of recovery. BetterHelp is one way that you can get the therapy that you're looking for and start working on your trauma. This online therapy system allows you to connect with therapists located throughout the country, and you can do it all from the comfort of your own home. There's no more need for heading out to the therapist's office when all you need to do is log on. Trained and licensed professionals are standing by to provide you with the tools needed to begin your road to recovery.