| DSM-IV Criterion | DSM-5 Criterion | Summary of Major Changes in DSM-5 |
|---|---|---|
| Criterion A: Traumatic event that involved: actual or threatened death, serious injury, OR threat to physical integrity AND Intense response of fear, helplessness, or horror | Criterion A: Traumatic event as defined by: direct exposure to, witnessing indirectly (by learning a close friend or close relative was exposed), OR repeated/extreme indirect exposure in the course of professional job (not through media) | Changes to wording of traumatic event exposure specification DROPPED Intense response of fear, helplessness, or horror criterion |
| Criterion B: Re-experiencing symptoms (1 or more): Intrusive recollections of events Recurrent distressing dreams of the event Acting or feeling as if the traumatic event were recurring Distress at internal or external reminders of the trauma Physiological reaction to internal or external reminders | Criterion B: Intrusion symptoms (1 or more): Recurrent, intrusive memories Traumatic nightmares Flashbacks Intense/prolonged distress after exposure Physiological reactivity upon exposure to cues | New title of criterion Changes to wording of criterion |
| Criterion C: Persistent avoidance and numbing (3 or more): Avoidance of thoughts, feelings, or conversations associated with trauma Avoidance of activities, places, or people that arouse recollections of trauma Failure to recall an important aspect of trauma Loss of interest or participation in significant activities Detachment from others Restricted range of affect Lost sense of the future | Criterion C: Persistent effortful avoidance of distressing trauma-related stimuli (1 or more): Trauma-related thoughts/feelings Trauma-related external reminders Criterion D: Negative cognitions/mood (2 of 7) Inability to recall key features of the trauma Negative beliefs about oneself, the world Distorted blame of self, others Persistent negative trauma-related emotions Diminished interest Feeling alienated, detachment/estrangement Constricted affect | Split avoidance and negative sequelae into 2 criteria Changes to wording of specific criterion |
| Criterion D: Hyperarousal (2 or more): Difficulty falling or staying asleep Irritability or outburst of anger Difficulty concentrating Hypervigilance Exaggerated startle response | Criterion E: Alterations in arousal and reactivity (2 or more): Irritable or aggressive behavior Self-destructive/reckless behavior Hypervigilance Exaggerated startle response Problems in concentration Sleep disturbance | New title of criterion Changes to wording of criterion Added self-destructive/reckless behavior |
| Criterion E: Duration of disturbance Duration of disturbance symptoms is more than 1 month | Criterion F: Duration of disturbance Duration of disturbance symptoms is more than 1 month | None |
| Criterion F: Clinically significant distress or impairment Duration of disturbance symptoms is more than 1 month | Criterion G: Clinically significant distress or impairment Duration of disturbance symptoms is more than 1 month | None |
| Criterion G: Exclusion criteria Symptoms are not due to medication, substance use, or other illness | Criterion H: Exclusion criteria Symptoms are not due to medication, substance use, or other illness | None |
DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; DSM-5 = Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.
From: Introduction
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