Table 1.

Comparison of DSM-IV TR criteria for PTSD to the proposed DSM-5 criteria

DSM-IV Criteria	Proposed DSM-5 Criteria
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.	The person was exposed to one or more of the following event(s): death or threatened death, actual or threatened serious injury, or actual or threatened sexual violation, in one or more of the following ways: ** Experiencing the event(s) him/herself Witnessing, in person, the event(s) as they occurred to others Learning that the event(s) occurred to a close relative or close friend; in such cases, the actual or threatened death must have been violent or accidental Experiencing repeated or extreme exposure to aversive details of the event(s) (e.g., first responders collecting body parts; police officers repeatedly exposed to details of child abuse); this does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.
The traumatic event is persistently reexperienced in one (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. Acting or feeling as if the traumatic event were recurring (flashbacks) Intense psychological distress at exposure to internal or external cues that symbolize or represent an aspect of the traumatic event. Physiological reactivity on exposure to internal or external cues that symbolize or represent an aspect of the traumatic event	Intrusion symptoms that are associated with the traumatic event(s) (that began after the traumatic event(s)), as evidenced by 1 or more of the following: Spontaneous or cued recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Recurrent distressing dreams in which the content and/or affect of the dream is related to the event(s). Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s) Marked physiological reactions to reminders of the traumatic event(s)
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 associate 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 Sense of foreshortened future	Persistent avoidance of stimuli associated with the traumatic event(s) (that began after the traumatic event(s)), as evidenced by efforts to avoid 1 or more of the following: Avoids internal reminders (thoughts, feelings, or physical sensations) that arouse recollections of the traumatic event(s) Avoids external reminders (people, places, conversations, activities, objects, situations) that arouse recollections of the traumatic event(s).
	Negative alterations in cognitions and mood that are associated with the traumatic event(s) (that began or worsened after the traumatic event(s)), as evidenced by 3 or more of the following: Inability to remember an important aspect of the traumatic event(s) (typically dissociative amnesia; not due to head injury, alcohol, or drugs). Persistent and exaggerated negative expectations about one’s self, others, or the world. Persistent distorted blame of self or others about the cause or consequences of the traumatic event(s) Pervasive negative emotional state -- for example: fear, horror, anger, guilt, or shame Markedly diminished interest or participation in significant activities. Feeling of detachment or estrangement from others. Persistent inability to experience positive emotions (e.g., unable to have loving feelings, psychic numbing)
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 Hypervigilance Exaggerated startle response	Alterations in arousal and reactivity that are associated with the traumatic event(s) (that began or worsened after the traumatic event(s)), as evidenced by 3 or more of the following: Irritable or aggressive behavior Reckless or self-destructive behavior Hypervigilance Exaggerated startle response Problems with concentration Sleep disturbance -- for example, difficulty falling or staying asleep, or restless sleep