Pediatric Oncall

Disorder Class : Trauma- and Stressor-Related Disorders

Exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways:

Directly experiencing the traumatic event(s).

Witnessing, in person, the event(s) as it occurred to others, especially primary caregivers.

Learning that the traumatic event(s) occurred to a parent or caregiving figure.

Note: Witnessing does not include events that are witnessed only in electronic media, television, movies, or pictures.

Presence of one or more of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:

Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).

Recurrent distressing dreams in which the content and/or effect of the dream are related to the traumatic event(s).

Dissociative reactions (e.g., flashbacks) in which the child feels or acts as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Such trauma reenactment may occur in play.

Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

Marked psychological reactions to reminders of the traumatic event(s).

One or more of the following symptoms, representing either persistent avoidance of stimuli associated with the traumatic event(s), or negative alterations in cognitions and mood associated with the traumatic event, must be present, beginning after the traumatic event(s) or worsening after the event.

Persistent avoidance of stimuli

Avoidance of or efforts to avoid places or physical reminders that arouse recollections of the traumatic event(s).

Avoidance of or efforts to avoid people, conversations, or interpersonal situations that arouse recollections of the traumatic event(s).

Negative alterations in cognitions

Substantially increased frequency of negative emotional states (e.g., fear, guilt, sadness, shame, confusion).

Markedly diminished interest or participation in significant activities, including constriction play

Social withdrawn behavior

Persistent reduction in expression of positive emotions.

Alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidence by two (or more) of the following:

Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects (including extreme temper tantrums).

Problems with concentration.

Hyper-vigilance.

Exaggerated startle response.

Duration of the disturbance is more than 1 month.

The disturbance causes clinically significant distress or impairment in relationships with parents, sibling, peers, or other caregivers or with school behavior.

Result :

DSM-5 diagnostic criteria not met.

Post-traumatic Stress Disorder - DSM-5 Criteria

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