Appendix 1: Diagnostic criteria for post-traumatic stress disorder19 The person has been exposed to a traumatic event in which both of the following were present The person experienced, witnessed or was confronted with an event or events that involved or threatened death or serious injury, or a threat to the physical integrity of self or others The person's response involved intense fear, helplessness or horror The traumatic event is persistently re-experienced in 1 or more of the following ways Recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions Recurrent distressing dreams of the event Actions or feelings as if the traumatic event were recurring (including a sense of reliving the experience, illusions, hallucinations and dissociative flashback episodes, including those that occur on awakening or when intoxicated) Intense psychologic distress resulting from exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event Physiologic reaction resulting from exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event Persistent avoidance of stimuli associated with trauma and numbing of general responsiveness, as indicated by 3 or more of the following Efforts to avoid thoughts, feelings or conversations associated with the trauma Efforts to avoid activities, places or people that arouse recollections of the trauma Inability to recall an important aspect of the trauma Markedly diminished interest or participation in significant activities Feeling of detachment or estrangement from others Restricted range of affect (e.g., patient is unable to have loving feelings) Sense of a foreshortened future (e.g., patient does not expect to have a career, marriage, children or a normal life span) Persistent symptoms of increased arousal, as indicated by 2 or more of the following Difficulty falling or staying asleep Irritability or outbursts of anger Difficulty concentrating Hypervigilance Exaggerated startle response Duration of the disturbance is more than 1 month Disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning

[Return to text]