A. 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 actual 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. Note that in children this may be expressed instead by disorganised or agitated behaviour.
B. The traumatic event is persistently re-experienced in one (or more) of the following ways:
- Recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions. Note that in young children repetitive play may occur in which themes or aspects of the trauma are expressed.
- Recurrent distressing dreams of the event. Note that in children these may be frightening dreams without recognisable content.
- Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note that in young children trauma-specific re-enactment may occur.
- Intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the traumatic event; physiological reactivity on exposure to internal or external cues that symbolise or resemble an aspect of the event.
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
- Efforts to avoid thoughts, feelings or conversations associated with the trauma.
- Efforts to avoid activities, places or people who 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. unable to have loving feelings).
- Sense of a foreshortened future (e.g. does not expect to have a career, marriage, children or a normal life span).
D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
- Difficulty falling or staying asleep.
- Irritability or outbursts of anger.
- Difficulty concentrating.
- Exaggerated startle response.
E. Duration of the disturbance (symptoms in Criteria B, C and D) is more than 1 month.
F. The disturbance causes clinically significant distress or impairment in social, occupational or other important areas of functioning.