DSM V PTSD Criteria Criterion A: stressor The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: (one required) 1. Direct exposure. 2. Witnessing, in person. 3. Indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental. 4. Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders, collecting body parts; professionals repeatedly exposed to details of child abuse). This does not include indirect non- professional exposure through electronic media, television, movies, or pictures. Criterion B: intrusion symptoms The traumatic event is persistently re-experienced in the following way(s): (one required) 1. Recurrent, involuntary, and intrusive memories. 2. Traumatic nightmares. 3. Dissociative reactions (e.g., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness. 4. Intense or prolonged distress after exposure to traumatic reminders. 5. Marked physiologic reactivity after exposure to trauma-related stimuli. Criterion C: avoidance Persistent effortful avoidance of distressing trauma-related stimuli after the event: (one required) 1. Trauma-related thoughts or feelings. 2. Trauma-related external reminders (e.g., people, places, conversations, activities, objects, or situations). Criterion D: negative alterations in cognitions and mood Negative alterations in cognitions and mood that began or worsened after the traumatic event: (two required) 1. Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol, or drugs). 2. Persistent (and often distorted) negative beliefs and expectations about oneself or the world (e.g., "I am bad," "The world is completely dangerous"). 3. Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences. 4. Persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt, or shame). 5. Markedly diminished interest in (pre-traumatic) significant activities.

6. Feeling alienated from others (e.g., detachment or estrangement). 7. Constricted affect: persistent inability to experience positive emotions. Criterion E: alterations in arousal and reactivity Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event: (two required) 1. Irritable or aggressive behavior 2. Self-destructive or reckless behavior 3. Hypervigilance 4. Exaggerated startle response 5. Problems in concentration 6. Sleep disturbance Criterion F: duration Persistence of symptoms (in Criteria B, C, D, and E) for more than one month. Criterion G: functional significance Significant symptom-related distress or functional impairment (e.g., social, occupational

Determine whether this veteran meets each of the diagnostic criteria for PTSD in the DSM-V. The criteria are listed above. When answering each question, please give specific evidence if you feel the criterion was met (e.g., Criterion D: "Feeling alienated from others: The veteran stated that he detached from everyone socially and emotionally").

• 1a. Did he meet Criterion A? Stressor- The person was exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence
• 1b. Did he meet Criterion B? Intrusion symptoms - The traumatic event is persistently re-experienced (one required)
• 1c. Did he meet Criterion C? Avoidance - Persistent effortful avoidance of distressing trauma-related stimuli after the event (one required)
• 1d. Did he meet Criterion D? Negative alterations in cognitions and mood - Negative alterations in cognitions and mood that began or worsened after the traumatic event (two required)
• 1e. Did he meet Criterion E? Alterations in arousal and reactivity - Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event (two required)
• 1f. Does he meet all criteria for a diagnosis of PTSD in the DSM-V, including Criterion F (duration) and G (impairment)?

PART 2

List at least one factor - referencing information from the lecture video on Risk Factors for PTSD (Lecture 4.3) - that put him at greater risk of PTSD. Or list at least one protective factor that helps him cope with PTSD. The risk/protective factor can be a pre-event, event, or post-event factor.

PART 3

Did he experience a potentially morally injurious event? If yes, please cite specific aspects of the case study that support that conclusion referring to the definition of potentially morally injurious events in lecture 4.5.