![]() Nearly 80% of clients seen in community mental health clinics have experienced at least one incident of trauma during their lifetime, representing roughly five out of every six clients (Breslau & Kessler, 2001). Keywords: trauma, post-traumatic stress disorder, PTSD, DSM-5, diagnostic, clinical utility This article highlights the changing conceptualization of trauma and how the DSM-5 definition impacts effective practices for assessing, conceptualizing and treating traumatized clients. With the recently released fifth edition of the DSM ( DSM-5), the definition of trauma and the diagnostic criteria for post-traumatic stress disorder have changed considerably. However, this mutable conceptualization of trauma and its aftermath have considerable implications for counseling practice. Researchers and trauma theorists agree that, with the exception of dissociative identity disorder, no other diagnostic condition in the history of the Diagnostic and Statistical Manual of Mental Disorders ( DSM ) has created more controversy with respect to the boundaries of the condition, diagnostic criteria, central assumptions and clinical utility than post-traumatic stress disorder. Specify if: Chronic: if duration of symptoms is 3 months or more.Trauma survivors are a unique population of clients that represent nearly 80% of clients at mental health clinics and require specialized knowledge on behalf of counselors. Specify if: Acute: if duration of symptoms is less than 3 months. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.į. Duration of the disturbance (symptoms in criteria B, C and D) is more than 1 month.į. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep). Marked 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: 6. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two or more of the following:Į. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.ĭ. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad ” “No one can be trusted ” “The world is completely dangerous ” “My whole nervous system is permanently ruined”). ![]() Persistent negative emotion state (e.g., fear, horror, anger, guilt, or shame). Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings). ![]() ![]() 6.įeelings of detachment or estrangement from others. Markedly diminished interest or participation in significant activities. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two or more of the following: 1. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).ĭ. ![]()
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