#PTSD DSM 5 CRITERIA CHECKLIST FREE#

#PTSD DSM 5 CRITERIA CHECKLIST FREE#

Once diagnosed with cancer, one is never truly free of the threat. What constitutes cessation of the traumatic stressor is unclear in cancer. In contrast to traumas that involve threats that are sudden, external, discrete, and immediate, cancer involves threats that are slowly unfolding (eg, detection, diagnosis, treatment, adverse effects), internal (ie, cancer cells), ever-present (ie, one’s body, potential disease recurrence), and future- oriented (eg, disease progression and death). These risk factors parallel known risk factors for PTSD following other traumas and suggest assessment targets in oncology ( Table).Ĭonceptual, diagnostic, and assessment issuesĭifferences between cancer and stressors traditionally viewed as traumatic per DSM (eg, war/combat, physical/sexual violence, motor vehicle accident, terrorism) have been recognized. 1,4 Younger age, lower socioeconomic status, past trauma, preexisting mental health conditions, more advanced disease, more intensive treatment, peritraumatic dissociation and distress, more recent treatment completion, and poor/negative social support have been linked to greater cancer-related PTSD. Several factors appear to confer vulnerability to developing PTSD symptoms following cancer. 7,8 This is consistent with what is often seen clinically: post-cancer trauma symptoms may coexist with finding meaning, strengthened relationships, enhanced spirituality, bolstered sense of personal strength, and clearer life priorities. Interestingly, a meta-analysis revealed a weak positive relationship between PTSD symptoms and posttraumatic growth in cancer patients. 6 Thus, although a small minority of patients with cancer may have diagnosable PTSD, subthreshold symptoms may be impairing and warrant clinical attention. Depression, anxiety, global distress, and quality-of-life decrements have been positively associated with post-cancer trauma symptoms. Other markers of distress have been linked with cancer-related PTSD. 5 The more stringent diagnostic criteria of DSM-5 have not been thoroughly evaluated in patients with cancer and may yield even lower rates. Another 10% to 20% of patients may experience subsyndromal PTSD symptomology. The clinical interview based prevalence was 6.4% for current PTSD and 12.6% for lifetime PTSD. 2,4 A meta-analysis by Abbey and colleagues 4 found that self-report based prevalence rates ranged from 7.3% to 11.2%, depending on method for determining clinical significance. 3 Prevalence varies according to mode of assessment, with self-report measures (eg, PTSD Checklist) yielding higher rates than structured clinical interviews (eg, SCID, CAPS). Individuals who have received a diagnosis of cancer appear to be more likely to experience PTSD than controls without a history of cancer. Across studies, more than 50% of patients with cancer meet the DSM-IV-TR stressor criteria (ie, they perceive cancer to involve a threat to their life or physical integrity), and they experience fear, helplessness, or horror. Prevalence estimates based on DSM-IV-TR criteria suggest that although self-reported symptoms are common, only a minority of patients with cancer meet formal diagnostic criteria for cancer-related PTSD. 1 However, changes to the DSM-5 PTSD criteria and more enduring conceptual issues call into question the applicability of PTSD to the cancer experience. DSM-IV-TR considered life-threatening illness as a potential traumatic stressor, inspiring a sizable literature documenting the prevalence and correlates of cancer- related PTSD. Although receiving a diagnosis of cancer is often colloquially referred to as traumatic, the validity and utility of the posttraumatic stress disorder (PTSD) construct in the context of malignant disease has been debated.

Ptsd dsm 5 criteria checklist