PTSD Diagnostic Criteria: Correct Statements
Options B, C, and D are correct; Option A is incorrect. The diagnostic criteria for PTSD explicitly include indirect trauma exposure, including learning about traumatic events affecting close others, making Option A false 1, 2.
Analysis of Each Option
Option A: FALSE - Direct Experience Not Required
This statement is incorrect. PTSD diagnosis explicitly recognizes multiple forms of trauma exposure beyond direct experience 1, 2:
- Direct experience of the traumatic event
- Witnessing trauma happening to others
- Learning that a traumatic event occurred to a close family member or friend
- Repeated exposure to aversive details of traumatic events (e.g., first responders) 1, 2
The American Psychiatric Association specifically defines traumatic exposure to include "learning about trauma" as a qualifying criterion 1. This represents a fundamental aspect of PTSD diagnosis that distinguishes it from requiring only firsthand experience.
Option B: CORRECT - Delayed Expression Specifier
This statement is accurate. The "delayed expression" specifier applies when full diagnostic criteria are not met until at least 6 months after the traumatic event 2. This acknowledges that:
- Some individuals develop the full syndrome months or years after trauma exposure
- Partial symptoms may be present initially, but the complete diagnostic picture emerges later
- This pattern is clinically significant and warrants specific documentation 2
Option C: CORRECT - Repetitive Play in Children Over 6
This statement is correct. In children older than 6 years, repetitive play expressing themes of the traumatic event represents a manifestation of intrusion symptoms 1. This developmental consideration recognizes that:
- Children express trauma-related distress differently than adults
- Play reenactment serves as a trauma processing mechanism
- This behavior qualifies as part of the intrusion symptom cluster required for diagnosis 1
Clinical pitfall to avoid: Focusing only on overt behaviors can lead to underestimation of distress in children with PTSD, as most symptoms are internal experiences 1, 3.
Option D: CORRECT - Indirect Trauma Exposure Qualifies
This statement is accurate and directly contradicts Option A. Learning that a friend or loved one experienced a traumatic event explicitly qualifies as exposure to a traumatic event 1, 2. The diagnostic criteria specify:
- Learning about actual or threatened death, serious injury, or sexual violence to a close family member or friend constitutes qualifying trauma exposure 1, 2
- This indirect exposure can trigger the full PTSD syndrome
- The relationship proximity matters—the traumatic event must involve someone close to the individual 2
Core Diagnostic Framework
Beyond these specific statements, PTSD diagnosis requires 1, 2:
- Duration: Symptoms persisting for more than 1 month (distinguishing it from Acute Stress Disorder, which occurs within the first month) 3
- Functional impairment: Clinically significant distress or impairment in social, occupational, or other important functioning 1, 2
- Symptom clusters: At least one intrusion symptom, one avoidance symptom, two negative alterations in cognition/mood, and two alterations in arousal/reactivity 1, 2
Common diagnostic pitfall: Many patients with PTSD do not voluntarily report symptoms, requiring direct screening rather than waiting for patients to self-identify 1. The American Academy of Pediatrics recommends directly asking if anything scary or concerning has happened since the last visit 1.