1. Exposure to threats of deaths or serious injury, or subjection to actual injury, that resulted in an intense emotional response of fear, helplessness, or horror.
2. Intrusive, distressing thoughts or images that recall that traumatic event.
3. Disturbing dreams associated with the traumatic event.
4. A sense that the event is recurring, as in illusions or flashbacks.
5. Intense distress when exposed to reminders of the traumatic event.
6. Physiological reactivity when exposed to internal or external cues that symbolize the traumatic event.
7. Avoidance of thoughts, feelings, or conversations about the traumatic event.
8. Avoidance of activities, places, or people associated with the traumatic event.
9. Inability to recall some important aspect of the traumatic event.
10. Lack of interest and participation in formerly meaningful activities.
11. A sense of detachment from others.
12. Inability to experience the full range of emotions, including love.
13. A pessimistic, fatalistic attitude regarding the future.
14. Sleep disturbance.
15. Irritability or angry outbursts.
16. Lack of concentration.
17. Hypervigilance.
18. Exaggerated startle response.
19. Symptoms have been present for more than 1 month.
20. Sad or guilty affect and other signs of depression.
21. Verbally and/or physically violent threats or behavior.
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