The DSM-IV and PTSD

DSM-IV

ciated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma

(2) efforts to avoid activities, places, or people that arouse recollections of the trauma

(3) inability to recall an important aspect of the trauma

(4) markedly diminished interest or participation in significant activities

(5) feeling of detachment or estrangement from others

(6) restricted range of affect (e.g., unable to have loving feelings)

(7) 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:

(1) difficulty falling or staying asleep

(2) irritability or outbursts of anger

(3) difficulty concentrating

(4) hypervigilance

(5) exaggerated startle response

Glossary

You must have at least three of the following:

Avoidance of thoughts about the traumatic event.

Avoidance of activities associated the traumatic event.

Inability to recall, or "blocking," say, a court date, or the name of a witness or victim.
Diminished interest, as mentioned, this is the "turning in to a couch-potato" experience reported by so many officer's.
Feeling detached or estranged: if you are the one that feels cut-off from others, it may be a symptom.
Restricted range of affect--you never get too happy. Or, you may never feel too sad.
Foreshortened future: Perhaps you can't see yourself as every living to retire, or ever having a marriage.
Has there been an increase, whether or not you notice it, since the trauma.

Sleep: Do you have trouble sleeping--for any reason.
Do you get angry for reasons you can't explain.
Concentration: Trouble getting organized, or forgetting things.
Hypervigilant: This is the "how I shot the Christmas tree" problem.
Exaggerated startle: Do you "jump" when the phone rings, or come straight up out of bed if you hear a noise in the middle of the night.

Additional commentary

Thoughts: Officer's often ask me, "how can I stop thinking about this stuff?" There are some specific techniques--ask your therapist.
Avoidant activities: Some officer's will drive miles out of their way to avoid the location of a traumatic event.

Blocking, i.e., memory problems; sometimes another way to avoid dealing with these problems.
Diminished interest in sex, food, work. One or all of theses areas may be affected.
One officer said "the whole world is a sewer--and everybody in it."
Restricted range of affect and sense of foreshortened future: Some respond to these symptoms by increased "risk-taking." One Agent I know would respond from anywhere in the Western US--if a door was going to be kicked, he was going to be the first one in.

What they want to know is whether or not any two of these symptoms have increased following a traumatic event.

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