1. 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:
    1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma
    2. Efforts to avoid activities, places, or people that arouse recollections of the trauma
    3. Inability to recall an important aspect of the trauma
    4. Markedly diminished interest or participation in significant activities
    5. Feeling of detachment or estrangement from others
    6. Restricted range of affect (e.g., unable to have loving feelings)
    7. Sense of foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)
  2. Persistent symptoms of increased arousal (not present before the trauma) as indicated by two (or more) of the following:
    1. Difficulty falling or staying asleep
    2. Irritability or outbursts of anger
    3. Difficulty concentrating
    4. Hypervigilance
    5. Exaggerated startle response
  3. Duration of the disturbance (symptoms in criteria B, C, and D) is more than one month.
  4. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.