DSM-5 Criteria for PTSD: Understanding the Neurobiological Alterations Behind the Disorder

Post-traumatic stress disorder (PTSD) is a complex and debilitating mental health condition that results from exposure to real or threatened death, serious injury, or sexual assault. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), PTSD is characterized by a range of symptoms that persist for more than one month after the traumatic event.

Recent studies have shed light on the neurobiological alterations that occur in individuals with PTSD, providing valuable insights into the underlying pathophysiology of this disorder. One of the key findings is that plasma neuropeptide Y concentration is reduced, along with decreased serotonin levels in the dorsal/median raphe region. This change in neurotransmitter dynamics likely affects the amygdala-hippocampus interaction, leading to increased symptoms.

Furthermore, research has shown that GABA activity is decreased, while glutamate levels are increased, promoting dissociation and derealization. Additionally, alterations have been observed in other neurotransmitter systems, including GABA, glutamate, serotonin, neuropeptide Y, and endogenous opioids.

The hypothalamic-pituitary-adrenal (HPA) axis is also affected in individuals with PTSD, characterized by normal to low levels of cortisol and elevated corticotropin-releasing factor (CRF). This imbalance leads to an increased sympathetic response, resulting in symptoms such as increased heart rate, blood pressure, arousal, and startle response.

The pathophysiology of PTSD involves alterations in neurotransmitter and neurohormonal functioning, which can have a significant impact on daily life. The DSM-5 criteria for PTSD include the following symptoms:

1. Persistently re-experiencing the traumatic event through intrusive thoughts, nightmares, flashbacks, or dissociative episodes.

2. Avoidance of stimuli associated with the traumatic event, such as people, places, or activities.

3. Hypervigilance and increased startle response.

4. Irritability, mood swings, and emotional dysregulation.

5. Sleep disturbances and concentration difficulties.

To be diagnosed with PTSD, symptoms must persist for more than one month after the traumatic event, with significant impairment in social, occupational, or other areas of functioning. The disorder often co-occurs with other mental health conditions and is associated with increased mortality rates, suicidal ideations, and attempts.

In conclusion, the DSM-5 criteria for PTSD highlight the complex interplay between neurotransmitters and neurohormones that underlie this disorder. Understanding these alterations can provide valuable insights into the development of effective treatment strategies for individuals affected by PTSD.

Dsm 5 ptsd criteria