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Can post-traumatic stress disorder (PTSD) be reliably diagnosed?

Charles J. Sophy, MD
Adolescent Medicine

Yes, an expert in PTSD can complete an in-depth review of the diagnostic methodology used in a case and reliably diagnoses PTSD using reliable and valid psychometric instruments.

The following are some basic facts about what constitutes a sound diagnosis of PTSD:

One of the critical components of a PTSD diagnosis is that the individual must have been exposed to a traumatic event. In order to qualify as a traumatic event, the event must meet two DSM criteria:

  • "the person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others." 
  • "the person's response involved intense fear, helplessness and horror." 

A second critical component of a PTSD diagnosis is that the person must have symptoms consistent with PTSD. Evidence of exposure to such a stressor alone is not sufficient to establish a diagnosis of PTSD.

The DSM-IV-TR specifies the pattern of symptoms that must occur in order for an individual to be diagnosed with PTSD. There are three categories of PTSD symptoms: re-experiencing, avoidance/numbing, and increased arousal. PTSD can only be diagnosed if one symptom of re-experiencing, three symptoms of avoidance/numbing, and two symptoms of increased arousal are present.

A third critical component of a PTSD diagnosis is that the person's level of functioning pre- and post-trauma must be significantly different. This is the requirement that symptoms "cause clinically significant distress or impairment in social, occupational, or other important levels of functioning." 

Finally, the symptoms of PTSD must persist beyond thirty days.

Yes. Although in the past post-traumatic stress disorder (PTSD) has often been misunderstood or misdiagnosed, a trained mental health professional should be able make an accurate diagnosis of the condition. PTSD has very specific and identifiable symptoms. (short list of questions) that will indicate whether or not they should be formally evaluated by a psychiatrist or clinical social worker. Do not be tempted to self-diagnose, or to diagnose others, because you think you are seeing symptoms of PTSD. Even a positive screen for PTSD may not mean that you have the condition. It may only mean you need to be assessed further by a mental health professional.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.