TPC-Journal-V4-Issue3

The Professional Counselor \Volume 4, Issue 3 262 repeated or extreme exposure to aversive details of such events, such as with first responders. Actual or threatened death must have occurred in a violent or accidental manner; and experiencing cannot include exposure through electronic media, television, movies or pictures, unless it is work-related. Table 1 Key Modifications to PTSD in DSM-5 PTSD Modifications Location New category: “Trauma- and Stressor-Related Disorders” No longer a subcategory of “Anxiety Disorders” Criteria A. Exposure Included sexual violence as a traumatic event Exposure refined to include: • Learning the event(s) occurred to close family or friend a , • Repeated or extreme exposure to details of the event(s) b , i.e., vicarious trauma. Removed A2, subjective response (i.e., fear, helplessness, horror) B. Intrusion (1 of 5) No major changes C. Avoidance (1 of 2) New separate criterion (factor) for avoidance symptoms No major changes to symptoms D. Negative Alterations in Mood/cognition (2 of 7) New criterion (factor) for numbing symptoms Two new symptoms: • Persistent negative emotional states • Persistent blame E. Arousal and Reactivity (2 of 6) One new symptom: • Reckless or self-destructive behavior F. Duration No change: Still 1 month since stressor G. Significance No change H. Not substance or medical Added criterion Specifiers Two types available: • With dissociative sx, i.e., depersonalization or derealization • With delayed expression of 6 or more months Subtype For children 6 years or younger (Preschool subtype) Separate criteria Note. sx = symptoms. Adapted from DSM-5 (APA, 2013a, p. 272). a Actual or threatened death must have been violent or accidental. b Such exposure through media, television, movies or pictures does not qualify unless for work.