Which of the following are core diagnostic features of PTSD?

• A. Intrusive memories, avoidance, negative alterations in cognition/mood, and hyperarousal
• B. Delusions, hallucinations, disorganized thinking, and flat affect
• C. Mood swings, grandiosity, decreased need for sleep, and impulsivity
• D. Social withdrawal, apathy, lack of motivation, and memory loss

Answer: (A)

PTSD diagnosis centers on four symptom clusters: intrusive memories, avoidance, negative alterations in cognition and mood, and hyperarousal. Intrusive memories are distressing recollections, flashbacks, or nightmares about the trauma. Avoidance involves efforts to avoid reminders of the event, including people, places, or thoughts. Negative alterations in cognition and mood encompass persistent negative beliefs, distorted blame, persistent negative emotional states, diminished interest in activities, detachment, and inability to experience positive emotions. Hyperarousal covers irritability or angry outbursts, hypervigilance, exaggerated startle, concentration problems, and sleep disturbance. For a PTSD diagnosis, these symptoms typically persist for more than a month and cause significant distress or impairment after exposure to a traumatic event.

The other symptom groupings fit different disorders: a cluster of delusions and hallucinations points to schizophrenia spectrum disorders; manic features like grandiosity, decreased need for sleep, and impulsivity indicate bipolar disorder; social withdrawal with apathy can occur in depression or schizophrenia, not PTSD.