TABLE 1.

Differences between DSM-IV-TR and DSM 5 for PTSD

DSM-IV-TR

DSM 5

Classification  “Anxiety disorders” Diagnostic criteria Criterion A2: after trauma there is fear, helplessness, or horror (removed in DSM 5) 3-symptom clusters: - Intrusion (re-experiencing) - Avoidance and numbing (separated into 2 criteria: criteria C [avoidance] and criteria D [negative alterations in cognitions and mood] in DSMV - Alterations in arousal and reactivity

Classification  “Trauma and stress or related disorders” Diagnostic criteria History of exposure to a traumatic event that meets specific stipulations (no requirement for fear, helplessness, or horror, as in DSM-IV-TR) Sexual assault and/or recurring exposure (i.e., as found in police officers and first responders) Revision criterion A1: unexpected death of family member or close friend due to natural causes no longer included as traumatic event 4-symptom clusters - Intrusion (re-experiencing) - Avoidance - Negative alterations in cognitions and mood -- Addition of persistent and distorted blame of self or others -- Addition of persistent negative emotional state - Alterations in arousal and reactivity -- Addition of reckless or destructive behavior Subtypes Addition of PTSD in children younger than 6 years Addition of PTSD with prominent dissociative symptoms (experiences of detachment from one’s own mind or body, or experiences in which world seems unreal, dreamlike, or distorted).

DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision; DSM 5: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PTSD: posttraumatic stress disorder