DMS-IV DIAGNOSTIC CRITERIA FOR PTSD
A. The person has been exposed to a trumatic event in which both the following were present:
(1) 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.
(2) The person's response involved intense fear, helplessness, or horror.
B. The traumatic event is persistently re-experienced in one (or more) of the following ways.
(1) Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions.
(2) Recurrent distressing dreams of the event.
(3) 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).
(4) Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
(5)Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
C. 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:
(1) Efforts to avoid thought feelings, or conversations associated with the trauma.
(2) Efforts to avoid activities, places, or people that arouse recollections of the trauma.
(3) Inability to recall an important aspect of the trauma.
(4) Markedly diminished interest or participation in significant activities.
(5) Feeling of detachment or estrangement from others. (6) Restricted range of affect (e.g., unable to have loving feelings). >br>(7) Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or normal life span).
D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
(1) Difficulty falling or staying asleep
( (2) Irritability or outbursts of anger
( (3) Difficulty concentrating
( (4) Hyper-vigilance
( (5) Exaggerated startle response
E. Duration of the disturbance (symptoms in Criteria B, C and D) is more that 1 month.
F. The disturbance causes clinically significant distress or impairment in social occupational, or other important areas of functioning.
Acute: if duration of symptoms is less than 3 months.
Chronic: if duration of symptoms is 3 months or more.
With Delayed Onset: if onset of symptoms is at least six months after the stressor.
WHAT IS ANGER?
Anger is the named feeling of agitation, frustration, indignation, exasperation, hostility or extreme displeasure. Anger can be expressed physically or emotionally towards oneself or others. Aggression may surface as a result of the anger causing one to engage in destructive behavior toward self, others or property. Aggression may manifest in verbal attacks, violent behavior, general hostility, threats toward self or others, or agitation. Anger is a powerful emotion that can take control in the strongest of individuals and seems to have a life of its own.
Anger is experienced in varied degrees from mild to extreme rage. When anger is expressed appropriately the outcome can be positive, promoting growth and facilitating change. When expressed in a negative or dangerous way, the results may include hurt feelings to self, family or friends, injury, and physical or emotional illness. Depression is a common outcome of anger.
Many veterans have angry feelings and a need to discuss and express their feelings in a safe way. It is better to express angry feelings than to keep them inside! Sooner or later the angry feelings will rise to the surface and the volcano will blow. It is better to let those feelings out with those who understand, those who have been there, have walked where you have walked, than to keep them inside where they can make you sick. There is safety and understanding in sharing your anger.
WHAT CAN I DO TO CONTROL MY ANGER?
A veteran can learn to control anger so that anger does not take control. Individuals can learn to express their anger in a safe, constructive manner with support from others.
Anger affects your relationships at work, within the family and all around you. It is important to let someone, such as a counselor, friend, or family member lend a listening ear.
Veterans can practice thinking before they act. Anger often leads to impulsivity, causing one to say or do something he regrets later. It is important to learn to walk away, calm down and think about the possible consequences. How can you express your angry feelings in a safe and constructive way?
It is important to learn the specific triggers to your anger. What leads to your angry outbursts? It is usually not about the thing or person at whom you are directing your anger at that moment! This can be enlightening and lead to healing.
Learn to do something "DISTRACTING" instead of "ATTACKING". Use empathy to understand whay someone seems to be attacking you. Develop healthy coping skills to use right away when you sense angry feelings stirring: a sport you love, take a walk, music, self time-out, talk to a support person, write in a journal about your anger, or draw what you are feeling. Your vet Center Counselor will help you develop a safety plan to have ready whenever you suddenly experience a trigger that could lead to an angry outburst. In time your fuse will lengthen.