Page 40 - Total War on PTSD

E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
1) Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects
2) Reckless and self-destructive behavior 3) Hyper-vigilance
4) Exaggerated startle response
5) Problems with concentration
6) Sleep disturbance
F. Duration of the disturbance is more than one month
G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
H. The disturbance is not attributable to the physiological effects of a substance (i.e., medication, alcohol) or another medical condition”
Source Cited: (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, VA: American Psychiatric Association.
Many combat Veterans will present in my office with trauma symptoms, but do not endorse enough of them to actually meet the criteria for PTSD. As noted above, individuals can have multiple symptoms, but if they do not have symptoms under each of these specific criteria, they will be given a different diagnosis based on the symptoms they do endorse. This is by no means minimizing their distress or level of symptomatology they do experience, instead, these individuals are given a diagnosis related to the disorder for which they meet criteria. These diagnoses may include an acute distress disorder (PTSD symptoms with a duration of three days to 30 days), generalized anxiety disorder, an adjustment disorder, a panic disorder, etc., just to name a few. Individuals with PTSD often have co-morbid conditions, such as depression and
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