![]() Key differences between DSM-IV and DSM-5 PTSD criteriaīroader definition of what constitutes a traumatic event ![]() ‘Recklessness or self-destructive behaviour’ has been added to the arousal cluster of symptoms. The avoidance cluster requires one of the two avoidance symptoms (avoidance of memories or thoughts or avoidance of external reminders), whereas the emotional numbing symptoms have been included in a new cluster of negative cognitions and mood, which also includes features typically associated with complex presentations of PTSD, such as persistent negative beliefs about self, others and the world. There are now four groups of symptoms as the previous grouping ‘avoidance and numbing’ has been separated into two distinct clusters. Sexual violence has been added as a specific example. The requirements for an event to be considered traumatic have been more explicitly defined and a subjective response of intense fear, helplessness or horror is no longer required to make a diagnosis. First, DSM-5 has separated ‘Trauma- and stressor-related disorders’ from the chapter on ‘Anxiety disorders’. Significant changes have been made to the way PTSD is classified and diagnosed ( Table 1). 5 These developments will be outlined, and the role of the GP in the management of PTSD considered.Īfter 19 years of the fourth edition (DSM-IV), the fifth edition (DSM-5) was released in May 2013. The first is the release of the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association, 4 and the second is the update of the Australian Guidelines for the Treatment of Acute Stress Disorder and Posttraumatic Stress Disorder (the Guidelines). In the past 18 months there have been two significant developments in the domain of post-traumatic mental health that have clinical relevance to GPs. ![]()
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