Anxiety Disorder (V)焦虑症(五): Posttraumatic Stress Disorder:创伤后应激障

A. The person has been exposed to a traumatic event in which both of the following were present:
患者经历过创伤事件,要有以下两个方面的表现:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
患者经历的,眼见的或者是遭遇到的一起或多起事件,这些事件是死亡,或是对生命安全有威胁,严重的创伤,自己或他人身体的完整性受到威胁.

(2) the person’s response involved intense fear, helplessness or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior
患者的反应是强烈的害怕,无助,恐惧.注意:对孩子来说,表现可能为强烈的不安.

B. The traumatic event is a persistently experienced in one (or more) of the following ways:
患者持续地经历这些创伤事件,表现如下:

(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.
这些事件反复地无法摆脱地一再入侵患者的想象,思想或觉知.注意:在儿童,患者在游戏时反复重复创伤事件的某个重要方面).

(2) recurrent distressing dreams of the event; Note: In children, there may be frightening dreams without recognizable content.
梦中反复重现创伤事件.注意:在儿童,可能表现为没有内容的恶梦.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.
行动或感觉犹如创伤事件正在发生(包括正生活在创伤事件中,妄想中,错觉中;清醒或不清醒时刻的不连续的事件回放).注意:在儿童,不自主地重新扮演创伤事件中特定的角色.

(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
每当暴露在内在的或外在的有关创伤事件的象征时,患者会有强烈的精神痛苦.

(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.
每当暴露在内在的或外在的有关创伤事件的象征时,患者会有身体上的反应.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:
患者持续回避与创伤事件有关的刺激,相对于创伤前来说,患者出现感觉麻木,可见以下三或更多状况:
(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma
努力去回避与创伤有关的思想,感觉,和对话

(2) efforts to avoid activities, places, or people that arouse recollections of the trauma
努力去回避会引起与创伤有关回忆的活动,场所,和人.

(3) inability to recall an important aspect of the trauma
不能忆起创伤事件的某个重要方面.

(4) markedly diminished interest or participation in significant activities
显著失去兴趣或参与某些重要活动

(5) feeling of detachment or estrangement from others
感觉与其他人有隔阂或疏远

(6) restricted range of affect (e.g., unable to have loving feelings)
情感局限(比如:不能感受到爱)

(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)感觉前途渺茫(如:不期望有职业前途,有婚姻,孩子,甚至是正常的寿命)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:
持续出现一些易于激惹的症状(创伤事件发生前不存在),可见如下表现:

(1) difficulty falling or staying asleep难于入睡或易醒

(2) irritability or outbursts of anger不安或易怒

(3) difficulty concentrating难于集中注意力

(4) hyper vigilance过于警觉

(5) exaggerated startle response惊吓反应过度

E. Duration of the disturbance (symptoms in Criteria B, C and D) is more than 1 month.
症状持续一个月以上

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
患者的症状达到临床诊断的显著痛苦