Prognosis varies many patients recover within months while some have symptoms that persist for years.These include substance use disorder, sleep difficulties, depression, anxiety, and social and occupational dysfunction r1 Often, these patterns are termed subthreshold trauma symptoms. Comorbid conditions and PTSD complications can cause significant distress. These symptoms can be transient, only arising in a specific context intermittent, appearing for several weeks or months and then receding or a part of the individual’s regular pattern of functioning (but not to the level of DSM-5 diagnostic criteria). The CAPS-5 is a structured interview designed to make a categorical PTSD diagnosis, as well as to provide a measure of PTSD symptom severity. Exhibit 1.3-4DSM-5 Diagnostic Criteria for PTSD Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).Evidence-based therapeutic modalities include prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing r4 r5 The PCL-5 is a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD (Weathers et al., 2013).The PCL-5 features an adapted answer scale ranging from 0 not at all to 4 extremely, thus making the theoretical lowest score 0. First line treatment is trauma-focused psychotherapy and/or serotonin reuptake inhibitors (eg, paroxetine, sertraline, venlafaxine) The PCL was revised to match the adapted DSM-5 criteria for PTSD.Ideally, diagnosis is confirmed by a trained mental health practitioner (eg, psychologist, psychiatrist, clinical social worker), often aided by a semistructured interviewing tool r2 r3 When suspected based on patient history, primary care clinicians can identify probable PTSD with a validated screening questionnaire, such as PC-PTSD-5 (Primary Care PTSD Screen for DSM-5).DSM-5-TR criteria are diagnostic for PTSD r1.The Acute Stress Disorder Scale (ASDS, 12) is a 14-item self-report measure of ASD. The psychometric properties of the ASDI-5 which was updated for DSM-5, have not yet been studied. The original ASDI (11) was developed and validated for the DSM-IV diagnostic criteria of ASD. Risk factors for PTSD (posttraumatic stress disorder) include occupational exposure to trauma (eg, military personnel, firefighters, police officers) threatened or actual physical or sexual assault being kidnapped or held hostage, a prisoner of war, or tortured experiencing natural or man-made disaster, interpersonal violence, a severe motor vehicle crash, or a sudden medical catastrophic event or witnessing a very stressful or traumatic event The Acute Stress Disorder Structured Interview 5 (ASDI-5, 1).
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