Question
Which of the following are core symptoms of PTSD? Re-experiencing/reliving the traumatic event, anxiety,functional impairment. Numbing, hyperarousal functional impairment. Avoidance, somatization functional impairment. All of the above.
Solution
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Answer
The core symptoms of PTSD fall into four categories:<br /><br />1. **Re-experiencing:** This includes intrusive memories, nightmares, flashbacks, and intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.<br /><br />2. **Avoidance:** Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event. Also, avoiding external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event.<br /><br />3. **Negative alterations in cognitions and mood:** This includes a range of symptoms, such as inability to remember an important aspect of the traumatic event, persistent and exaggerated negative beliefs or expectations about oneself, others, or the world ("No one can be trusted."), persistent distorted cognitions about the cause or consequences of the traumatic event that lead the individual to blame himself/herself or others, persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame), markedly diminished interest or participation in significant activities, feelings of detachment or estrangement from others, and persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).<br /><br />4. **Marked alterations in arousal and reactivity:** This cluster includes symptoms such as irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or physical aggression toward people or objects, reckless or self-destructive behavior, hypervigilance, exaggerated startle response, problems with concentration, and sleep disturbances (e.g., difficulty falling or staying asleep or restless sleep).<br /><br />**Functional impairment** is a consequence of PTSD, not a core symptom itself. While it's a critical aspect of the diagnosis (the symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning), it's not one of the four main symptom categories.<br /><br />Therefore, the closest correct answer is **Numbing (which falls under negative alterations in cognitions and mood), hyperarousal (which falls under marked alterations in arousal and reactivity), and while functional impairment isn't a symptom *itself*, it's a *result* of the symptoms, and its presence is necessary for a PTSD diagnosis.** None of the provided options are perfectly worded, but this is the best fit given the choices.<br />
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