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Hypervigilance5.Ğxaggerated startle response Irritability or outbursts of anger3.ĝifficulty concentrating4. 1.ĝifficulty falling or staying asleep2.Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following: Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span). Restricted range of affect (e.g., unable to have loving feelings) . Feeling of detachment or estrangement from others . Markedly diminished interest or participation in significant activities. Inability to recall an important aspect of the trauma. Efforts to avoid activities, places, or people that arouse recollections of the trauma . 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. Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.ĭSM-IV-TR Criteria: PTSD C. (Note: In young children, trauma-specific reenactment may occur.) Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event. (Note: In children, there may be frightening dreams without recognizable 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: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.) Recurrent distressing dreams of the event. 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: In children, this may be expressed instead by disorganized or agitated behavior.ĭSM-IV-TR Criteria: PTSD B.The person's response involved intense fear, helplessness, or horror.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 has been exposed to a traumatic event in which both of the following were present:.Arousal and reactivity symptoms (Criterion E).Cognitions and Mood: negative alterations (Criterion D).Avoidance of stimuli associated with the trauma (Criterion C).Exposure to actual or threatened a) death, b) serious injury, or c) sexual violation: direct experiencing, witnessing (Criterion A).Functional impairment due to disturbancesĭSM-5 ® Nutshell Definition of PTSD(Posttraumatic Stress Disorder ) (American Psychiatric Association, 2013).Duration of symptoms longer than 1 month.Avoidance of stimuli associated with the trauma.Actual or perceived threat of injury or death - response of hopelessness or horror (Criterion A).Trauma: Large-T or “Big” T Examples include: combat, natural disasters, sexual abuse, assault, other violent crimes “Big T” trauma is what the psychological community references in speaking about the PTSD diagnosis.ĭSM-IV-TR Nutshell Definition of PTSD(Posttraumatic Stress Disorder ) (APA, 2000) “Once you’ve been bitten by a snake, you’re afraid even of a piece of rope.”-Chinese Proverb
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Discuss how the new DSM-5® will impact the helping profession’s conceptualization of clinical trauma.Articulate how other diagnoses in the DSM may be better explained by trauma, or exacerbated by the effects of unresolved trauma.List and discuss the diagnoses covered in the new DSM-5® chapter, Trauma and Stressor-Related Disorders.Define trauma and describe, in a general sense, how unresolved trauma may manifest in clinical settings.Creator of the Dancing Mindfulness practice.Trained in several specialty interventions for trauma.Specialist in addictions, trauma, abuse, dissociative disorders, performance enhancement, grief/loss, and pastoral counseling.Thirteen years of experience working in social services and counseling includes three years of experience in civilian humanitarian aid in Bosnia-Hercegovina.Author, EMDR Made Simple & Trauma and the Twelve Steps.Member of the American Academy of Experts on Traumatic Stress.Licensed Supervising Independent Chemical Dependency Counselor.Licensed Supervising Professional Clinical Counselor (MH).Director, Mindful Ohio Affiliate Faculty, IATP *This training is not affiliated with the American Psychiatric Association Trauma and the DSM-5®* Jamie Marich, Ph.D., LPCC-S, LICDC-CS.