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Post-Traumatic Stress Disorder, also known simply as PTSD, is a long-term condition that can set in after any traumatic event. It transforms the victim's life in such a way that the trauma continues to dominate them, and sucks joy while promoting anger and depression.
When we think about PTSD, we usually immediately imagine combat veterans, rape victims, and survivors of natural catastrophes such as earthquakes. But proposed changes in the recently published Diagnostic Manual of Mental Disorders (the DSM-5) change the diagnostic criteria for PTSD in such a way that recognizes the condition can be caused by racism.
The previous version of the DSM, the “Bible of mental disorders”, recognized that racism could lead to PTSD only in case of an identifiable incident. The DSM-5 acknowledges that racism is so bad that being exposed to it over a lifetime can actually cause Post-Traumatic Stress Disorder.
PTSD In The DSM-5
The American Psychiatric Association frequently updates its diagnostic criteria for mental disorders, in line with the latest research in the field. The DSM-5 came out in May 2013, and PTSD is now part of a new chapter titled “Trauma- and Stressor-Related Disorders”. The diagnostic criteria for PTSD were altered, and a new sub-type of the disorder was introduced for children under six.
So, what has changed? Before we look at the diagnostic criteria, it should be pointed out that the DSM-IV contained three symptom clusters. Those have now been divided into four to facilitate the separation of avoidance and numbing into two: avoidance (Criterion C) and negative alternations in cognition and mood (Criterion D).
Three new PTSD symptoms were added to the list. Persistent and distorted blame of self or others and a persistent negative emotional state appear under Criterion D. Reckless and destructive behavior was added under Criterion E.
A clinical subtype of PTSD in which the victim experiences dissociative symptoms was also added.
There are now eight separate diagnostic criteria. Under each of these criteria, one or more symptoms are required for PTSD to be diagnosed, depending on the individual criterion. These diagnostic criteria are as follows in the DSM-5:
Criterion A: Exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. This can be through direct exposure, experienced in person. It can also be indirect, by learning that a friend or relative was exposed to trauma, or acquired during the course of professional duties (think of police officers and medical professionals dealing with emergencies).
Criterion B: The traumatic event is, or the traumatic experiences are, persistently relived — commonly through intrusive memories, flashbacks, nightmares, or distress after exposure to triggers that remind the victim of the event(s).
Criterion C: The victim must make a persistent effort to avoid stimuli that remind them of the trauma. This includes avoiding trauma-related thoughts or feelings and avoiding places, people, objects, and conversations that may remind the person of the trauma.
Criterion D: “Negative alterations in cognition and mood” that can involve the inability to feel positive emotions, feeling alienated from others, and negative feelings about self or the rest of the world. Not being able to recall parts of the traumatic event also falls under this heading, as does a diminished interest in activities previously significant to the person.
Criterion E: Irritable or aggressive behavior, reckless of self-destructive tendencies, hypervigilance and an exaggerated startle response, sleep difficulties and concentration problems.
Criterion F: Persistence of required symptoms from previous categories for more than one month.
Criterion G: “Significant symptom-related distress or functional impairment” — in order words, the experienced symptoms have to disrupt the victim's life significantly.
Criterion H: The symptoms aren't due to substance abuse, medication, or other illnesses.