In diagnosing PTSD, clinicians need to ascertain that patients experienced a traumatic event and that they involuntarily re-experience the event. In addition, patients will show symptoms of hyperarousal, avoidance, and emotional numbing. Self-report instruments such as the Post-traumatic Stress Diagnostic Scale (29) or semistructured interviews such as the Clinician Administered PTSD Scale(25) are useful in assessing the symptom pattern. The DSM-IV criterion of a minimum of three avoidance or numbing symptoms appears too strict for clinical purposes. It does not appear justified to withhold treatment if the patient is distressed by the PTSD symptoms but fails to meet this criterion.
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