Table 1 Comparison of diagnostic criteria for (complex) PTSD based on DSM-IV, DSM-5, ICD-10, ICD-11

Intrusion

Intrusive thoughts, flashbacks, disturbing dreams

1

Repeated, sudden thoughts about the traumatic experience?

I (at least one symptom, items 1—5)

I (at least one symptom, items 1—5)

I (at least one symptom, items 1—5)

2

Repeated disturbing dreams about the experience?

I

I

I

I (at least one symptom, items 2, 3)

I (at least one symptom, items 2, 3)

3

Suddenly acting as though the experience was happening again?

I

I

I

I

I

Physical/psychological reactions to reminders of trauma

4

Feeling very upset when reminded of the experience?

I

I

I

5

Having strong physical reactions (e.g. dizziness, heart palpitations, chest pain, shortness of breath) when reminded of the event?

I

I

I

Avoidance

Internal avoidance

6

Avoid thinking about the event?

AN (at least three symptoms, items 6—10, 20, 21)

A (at least one symptom, items 6, 7)

A (at least one symptom, items 6, 7)

A (at least one symptom, items 6, 7)

A (at least one symptom, items 6, 7)

External avoidance

7

Avoid people, places, talking, activities, things, or situations about the event?

AN

A

A

A

A

Numbing

Diminished interest

8

Losing interest in things you used to enjoy (e.g., walking, reading, socializing, cooking, gardening)

AN

AD

Foreshortened future

9

Feeling hopeless about the future

AN

Hyperarousal

Inability to recall/posttraumatic amnesia

10

Difficulty remembering some important parts of the event?

AN

AD (at least two symptoms, items 8, 10, 17—19, 20, 21)

H (inability to recall or at least two other symptoms, items 10—15)

Insomnia

11

Trouble falling or staying asleep?

H

H

Irritability

12

Feeling irritable, angry, or aggressive towards people?

H (at least two symptoms, items 12—15)

H (at least two symptoms, items 11—16)

H

AD

Concentration problems

13

Having difficulty concentrating (e.g., at work/school)?

H

H

H

Hypervigilance

14

Being on guard constantly when there was no real reason to be?

H

H

H

H (at least one symptom, items 14, 15)

H (at least one symptom, items 14, 15)

Exaggerated startle response

15

Feeling suddenly scared for no reason?

H

H

H

H

H

Self-destructive behaviour

16

Try to do something that you know may cause you or other people harm?

H

Affect dysregulation

Persistent negative emotions

17

Having strong feelings such as shame, fear, horror, anger, or guilt?

AD

AD (persistent negative emotions)

Negative self-concept

18

Having strong negative beliefs about yourself, others, or the world in general?

AD

NS (at least one symptom, items 18, 19)

19

Blaming yourself or others constantly for the event or what happened as a result of the event?

AD

NS

Interpersonal problems

20

Feeling cut off or trying to stay away from people?

AN

AD

IP (at least one symptom, items 20, 21)

21

Having difficulty experiencing positive emotions (e.g. love, happiness) for another person?

AN

AD

IP