Trauma and Stressor Related Disorders

Reactive attatchment disorder - A (2 total)

A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following

The child rarely or minimally seeks comfort when distressed

The child rarely or minimally responds to comfort when distressed

Reactive attatchment disorder - B (3 total)

A persistent social and emotional disturbance characterized by at least two of the following

Minimal social and emotional responsiveness to others

Limited positive affect

Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers.

Reactive attatchment disorder - C (Care)

The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following

Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults

Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care)

Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child-to-caregiver ratios).

Reactive attatchment disorder - exclusionary criteria

The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A

The criteria are not met for autism spectrum disorder.

Reactive attatchent disorder - minimum duration

The disturbance is evident before age 5 years

The child has a developmental age of at least 9 months

Disinhibited social engagement disorder - A (4 total)

A pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following

Reduced or absent reticence in approaching and interacting with unfamiliar adults

Overly familiar verbal or physical behavior (that is not consistent with culturally sanctioned and with age-appropriate social boundaries)

Diminished or absent checking back with adult caregiver after venturing away, even in unfamiliar settings

Willingness to go off with an unfamiliar adult with minimal or no hesitation

Disinhibited social engagement disorder - C (Care)

The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following

Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults

Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care)

Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child-to-caregiver ratios)

Disinhibited social engagement disorder - exclusionary criteria

The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A

The behaviors in Criterion A are not limited to impulsivity (as in attentiondeficit/hyperactivity disorder) but include socially disinhibited behavior

Disinhibited social engagement disorder - minimum duration

The child has a developmental age of at least 9 months

Posttraumatic stress disorder - A (exposure criteria) (4 total)

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways

Directly experiencing the traumatic event(s)

Witnessing, in person, the event(s) as it occurred to others

Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental

Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse). Does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.

PTSD - Symptom clusters (4 total)

Intrusion symptoms - 1/5

Avoidance symptoms - 2/2

Negative alterations in cognitions and mood - 2/7

Marked alterations in arousal and reactivity - 2/6

PTSD - Intrusion symptoms (B) (5 total)

Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred

Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s)

Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s)

Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)

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 internal or external cues that symbolize or resemble an aspect of the traumatic event(s)

PTSD - avoidance symptoms (C) (2 total)

Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following

Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s)

Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

PTSD - Negative alterations in cognitions and mood (D) (7 total)

Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs)

Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous,” “My whole nervous system is permanently ruined”)

Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others

Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame)

Markedly diminished interest or participation in significant activities.

Feelings of detachment or estrangement from others

Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

PTSD - marked alterations in arousal and reactivity (E) (6 total)

Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects

Reckless or self-destructive behavior

Hypervigilance

Exaggerated startle response

Problems with concentration

Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

PTSD - minimum duration

More than 1 month in all symptom clusters

PTSD - G

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

Acute stress disorder - A (exposure criteria)

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways

Directly experiencing the traumatic event(s)

Witnessing, in person, the event(s) as it occurred to others

Learning that the event(s) occurred to a close family member or close friend. Note: In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental

Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains, police officers repeatedly exposed to details of child abuse)

Acute stress disorder - B

B. Presence of nine (or more) of the symptoms from any of the five categories of intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening after the traumatic event(s) occurred

Note: same criteria for PTSD, exept:

Intrusion - Marked physiological responce / extreme prolonged distress in responce to external cues are merged

Avoidance - criteria are identical

Mood/cognitions - only 1 criterion total: inability to experience positive affect

Arousal & reactivity - self destructive behaviour is not included

One more cluster: 2 additional dissasociative criteria

1. Depersonalisation and or derealisation,

2. Dissasociative amnesia

Acute stress disorder - minimum duration

Duration of the disturbance is 3 days to 1 month after trauma exposure

Adjustment disorders - A

The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s)

Adjustment disorder - B (2 total)

These symptoms or behaviors are clinically significant, as evidenced by one or both of the following

Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation

Significant impairment in social, occupational, or other important areas of functioning

Adjustment disorder - exclusionary criteria

The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a preexisting mental disorder

The symptoms do not represent normal bereavement and are not better explained by prolonged grief disorder

Adjustment disorder - minimum duration

Symptom onset occuring within 3 months of stressor

Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months

Prolonged grief disorder (learn chill) - A

The death, at least 12 months ago, of a person who was close to the bereaved individual (for children and adolescents, at least 6 months ago).

Prolongedgrief disorder (learn chill) - B (2 total)

Since the death, the development of a persistent grief response characterized by one or both of the following symptoms, which have been present most days to a clinically significant degree. In addition, the symptom(s) has occurred nearly every day for at least the last month

Intense yearning/longing for the deceased person

Preoccupation with thoughts or memories of the deceased person (in children and adolescents, preoccupation may focus on the circumstances of the death).

Prolonged grief disorder (learn chill) - minimum duration

Death at least 12 months ago

Criterion B symptoms present most days overall

Criterion B symptoms present most days for the past month

Criterion C symptoms present most days since death

Prolonged grief disorder (learn chill) - C (8 total)

Since the death, at least three of the following symptoms have been present most days to a clinically significant degree. In addition, the symptoms have occurred nearly every day for at least the last month

Identity disruption (e.g., feeling as though part of oneself has died) since the death

Marked sense of disbelief about the death

Avoidance of reminders that the person is dead (in children and adolescents, may be characterized by efforts to avoid reminders)

Intense emotional pain (e.g., anger, bitterness, sorrow) related to the death

Difficulty reintegrating into one’s relationships and activities after the death (e.g., problems engaging with friends, pursuing interests, or planning for the future)

Emotional numbness (absence or marked reduction of emotional experience) as a result of the death

Feeling that life is meaningless as a result of the death

Intense loneliness as a result of the death