5. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic. 6. The episode is not attributable to the physiological effects of a substance (examples: a drug of abuse, a medication, other treatment). Posttraumatic stress disorder 1. 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) (examples: first responders collecting human remains; police officers repeatedly exposed to details of child abuse). 2. 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 event(s). • Recurrent distressing dreams in which the content and/or effect of the dream are related to the traumatic event(s). • Dissociative reactions (example: flashbacks) in which the individual feels or acts as if the traumatic event(s) are/were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings. • Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events(s). • Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). 3. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following: • Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic events(s).
257
Made with FlippingBook - professional solution for displaying marketing and sales documents online