Methods of Characterization Review of Related Theories

23 1. Exposure to Actual or Threatened Death, Serious Injury, or Sexual Violence in One or More Ways There are some exposures included in this criterion. Those exposures are directly experiencing the traumatic events, witnessing the events as it occurred to others in person, learning that the traumatic events occurred to close family member or close friend, learning actual or threatened death of a family member or friend which is violent or accidental, and experiencing repeated or extreme exposure to concrete details to the traumatic events. 2. Presence of One Or More of Intrusion Symptoms Associated with the Traumatic EventS after the Traumatic EventS Are Occurred The criterion includes five intrusion symptoms, namely recurrent or involuntary and intrusive distressing memories of the traumatic events, recurrent distressing dreams in which the content andor affect of the dream are related to the traumatic events, dissociative reactions in which the individual feels or act as if the traumatic events were recurring, intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic events, and marked psychological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic events. 3. Persistence Avoidance of Stimuli Associated with the Traumatic Events which Begins after the Traumatic Events Occurred This persistence avoidance is classified into two. The first is the avoidance or efforts to avoid distressing memories, thought, and feelings about or closely 24 associated with the traumatic events. The second is the avoidance or efforts to avoid external reminders people, places, conversations, activities, objects, situations which arouse distressing memories, thought, and feelings about or closely associated with the traumatic events. 4. Negative Alterations in Cognitions and Mood Associated with the Traumatic Events which Begins or Worsens after the Traumatic Events Occurred The negative alterations are identified by some changes in an individual. They are the inability to remember an important aspect of the traumatic events due to dissociative amnesia, the persistent and exaggerated negative beliefs or expectations about oneself, others, or the world, the persistent distortive cognitions about the cause or consequences of the traumatic events that lead the individual to blame himselfherself or others, the persistent negative emotional state e.g., fear, horror, anger, guilt, or shame, the markedly diminished interest or participation in significant activities, the feelings of detachment or estrangement from others, and the persistent inability to experience positive emotions e.g., inability to experience happiness, satisfaction, or loving feelings. 5. Marked Alterations in Arousal and Reactivity Associated with the Traumatic Events which Begins or Worsens after the Traumatic Events Occurred The marked alterations are identified by some irritable behaviors and angry outbursts with little provocation. They are typically expressed as verbal or physical aggression towards people or objects, reckless or self – destructive 25 behavior, exaggerated vigilance, exaggerated startle response, problems with concentration, and sleep disturbance.

6. Duration of the Disturbance Is More Than 1 Month

This criterion implies that disturbances stated in the previous criteria happen for more than one month after the traumatic event. If the duration of the disturbances does not last for more than one month, an individual does not suffer from PTSD. The disturbances may indicate an immediate reaction to traumatic event instead of PTSD. 7. The Disturbance Causes Clinically Significant Distress or Impairment in Social, Occupational, or Other Important Areas of Functioning If the set of disturbances stated in the previous criteria does not cause clinically significant distress or impairment, the individual does not suffer from PTSD as well. The set of disturbances is identified as PTSD when it causes clinically significant distress or impairment of an individual. 8. The Disturbance Is Not Attributable to the Physiological Effects of a Substance e.g., Medication, Alcohol or another Medical Condition This last criter ion implies that the set of PTSD‟s disturbances should not be attributable to the physiological effects of a medication, alcohol, or other medical condition. If the set of disturbances is attributable to the effect of substances, it is not considered as PT SD‟s disturbances.