Acute
Stress
Disorder
Post
Traumatic Adjustment
Stress Disorder
Disorder Trauma &
Stressor
Related
Disorders
Disinhibited Reactive
Soical
Engagement
Attachment
Disorder Disorder
- Stressors- external events or situations that place physical or
psychological demands on us
- Stressor is the thing that causes you stress
- Stress is the internal psychological or physiological response to stressor
- Stress negatively influence health
Acute Stress Disorder
DSM-5 diagnostic criteria for Acute Stress Disorder
A. Exposure to actual or threatened death, serious injury, or sexual violation in
one (or more) of the following ways:
• Directly experiencing the traumatic event(s).
• Witnessing in person the event(s) as it occurred to others.
• Learning that the traumatic event(s) occurred to a close family member or
close friend. In cases of actual or threatened death of a family member or
friend, the event(s) must have been violent or accidental.
• Experiencing repeated or extreme exposure to aversive details of the
traumatic event(s) (e.g., first responders collecting human remains; police
officers repeatedly exposed to details of child abuse).
,Note: Criterion A4 does not apply to exposure through electronic media, television,
movies, or pictures, unless this exposure is work related.
B. Presence of nine (or more) of the following symptoms from any of the five
categories of intrusion, negative mood, dissociation, avoidance, and arousal,
beginning or worsening after the traumatic event(s) occurred:
Intrusion Symptoms
• Recurrent, involuntary, and intrusive distressing memories of the traumatic
event(s).
Note: In children repetitive play may occur in which themes or aspects of the
traumatic event(s) are expressed.
• Recurrent distressing dreams in which the content and/or affect of the dream
are related to the traumatic event(s).
Note: In children, there may be frightening dreams without recognizable content.
• Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as
if the traumatic event(s) were recurring. (Such reactions may occur on a
continuum, with the most extreme expression being a complete loss of
awareness of present surroundings.)
Note: In children, trauma-specific reenactment may occur in play.
• Intense or prolonged psychological distress or marked physiological reactions
in response to internal or external cues that symbolize or resemble an aspect
of the traumatic event(s).
Negative Mood
• Persistent inability to experience positive emotions (e.g., inability to
experience happiness, satisfaction, or loving feelings).
Dissociative Symptoms
• An altered sense of reality of one’s surroundings or oneself (e.g., seeing oneself
from another’s perspective, being in a daze, time slowing).
• Inability to remember an important aspect of the traumatic event(s) typically
due to dissociative amnesia and not to other factors such as head injury,
alcohol, or drugs).
• Irritable behavior and angry outbursts (with little or no provocation) typically
expressed as verbal or physical aggression toward people or objects.
• Hyper vigilance.
• Problems with concentration.
• Exaggerated startle response.
Avoidance Symptoms
• Efforts to avoid distressing memories, thoughts, or feelings about or closely
associated with the traumatic event(s).
• Efforts to avoid external reminders (people, places, conversations, activities,
objects, situations) that arouse distressing memories, thoughts, or feelings
about or closely associated with the traumatic event(s).
Arousal Symptoms
• Sleep disturbance (e.g., difficulty falling or staying asleep, or restless sleep).
, C. Duration of the disturbance (symptoms in Criterion B) is 3 days to 1
month after trauma exposure.
Note: Symptoms typically begin immediately after the trauma, but persistence for at
least three days and up to a month is needed to meet disorder criteria.
D. The disturbance causes clinically significant distress or impairment in social
occupational, or other important areas of functioning.
E. The disturbance is not attributable to the physiological effects of a substance
(e.g., medication, alcohol) or another medical condition (e.g., mild traumatic
brain injury) and is not better explained by brief psychotic disorder.
Posttraumatic Stress Disorder
DSM-5 diagnostic criteria for Posttraumatic Stress Disorder
Note: The following criteria apply to adults, adolescents, and children older than 6
years.
A. Exposure to actual or threatened death, serious injury, or sexual violence in
one (or more) of the following ways:
• Directly experiencing the traumatic event(s).
• Witnessing in person the event(s) as it occurred to others.
• Learning that the traumatic event(s) occurred to a close family member or
close friend. In cases of actual or threatened death of a family member or
friend, the event(s) must have been violent or accidental.
• Experiencing repeated or extreme exposure to aversive details of the
traumatic event(s) (e.g., first responders collecting human remains; police
officers repeatedly exposed to details of child abuse).
Note: Criterion A4 does not apply to exposure through electronic media, television,
movies, or pictures, unless this exposure is work related.
B. Presence of one (or more) of the following intrusion symptoms associated
with the traumatic event(s), beginning after the traumatic event(s) occurred:
• Recurrent, involuntary, and intrusive distressing memories of the traumatic
events.
Note: In children older than 6 years, repetitive play may occur in which themes or
aspects of the traumatic event(s) are expressed.
• Recurrent distressing dreams in which the content and/or affect of the dream
are related to the traumatic event(s).
Note: In children, there may be frightening dreams without recognizable content.
Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the
traumatic event(s) were recurring. (Such reactions may occur on a continuum, with
the most extreme expression being a complete loss of awareness of present
surroundings.)
1.