<unk>  can be difficult to diagnose, because of: * the subjective nature of most of the diagnostic criteria (although this is true for many mental disorders); * the potential for over-reporting, e.g., while seeking disability benefits, or when<unk>  could be a mitigating factor at criminal sentencing * the potential for under-reporting, e.g., stigma, pride, fear that a<unk>  diagnosis might preclude certain employment opportunities; * symptom overlap with other mental disorders such as obsessive compulsive disorder and generalized anxiety disorder; * association with other mental disorders such as major depressive disorder and generalized anxiety disorder; * substance use disorders, which often produce some of the same signs and symptoms as<unk> ; and * substance use disorders can increase vulnerability to<unk>  or exacerbate<unk>  symptoms or both; and *<unk>  increases the risk for developing substance use disorders. *the differential expression of symptoms culturally (specifically with respect to avoidance and numbing symptoms, distressing dreams, and somatic symptoms) Screening There are a number of<unk>  screening instruments for adults, such as the<unk>  Checklist for DSM-5 (PCL-5) and the Primary Care<unk>  Screen for DSM-5 (PC-PTSD-5). There are also several screening and assessment instruments for use with children and adolescents. These include the Child<unk>  Symptom Scale (CPSS), Child Trauma Screening Questionnaire, and UCLA<unk>  Reaction Index for DSM-IV. In addition, there are also screening and assessment instruments for caregivers of very young children (six years of age and younger). These include the Young Child<unk>  Screen, the Young Child<unk>  Checklist, and the Diagnostic Infant and Preschool Assessment. Assessment Evidence-based assessment principles, including a multimethod assessment approach, form the foundation of<unk>  assessment. Diagnostic and statistical manual<unk>  was classified as an anxiety disorder in the DSM-IV, but has since been reclassified as a "trauma- and<unk> or-related disorder" in the DSM-5. The DSM-5 diagnostic criteria for<unk>  include four symptom clusters: re-experiencing, avoidance, negative alterations in cognition/mood, and alterations in arousal and reactivity. International classification of diseases The International Classification of Diseases and Related Health Problems 10 (ICD-10) classifies<unk>  under "Reaction to severe<unk> , and adjustment disorders." The ICD-10 criteria for<unk>  include re-experiencing, avoidance, and either increased reactivity or inability to recall certain details related to the event. The ICD-11 diagnostic description for<unk>  contains three components or symptom groups (1) re-experiencing, (2) avoidance, and (3) heightened sense of threat. ICD-11 no longer includes verbal thoughts about the<unk>  event as a symptom. There is a predicted lower rate of diagnosed<unk>  using ICD-11 compared to ICD10 or DSM-5. ICD-11 also proposes identifying a distinct group with complex<unk>  (CPTSD), who have more often experienced several or sustained traumas and have greater functional impairment than those with<unk> . Differential diagnosis A diagnosis of<unk>  requires that the person has been exposed to an extreme<unk> or. Any<unk> or can result in a diagnosis of adjustment disorder and it is an appropriate diagnosis for a<unk> or and a symptom pattern that does not meet the criteria for<unk> . The symptom pattern for acute<unk>  disorder must occur and be resolved within four weeks of the trauma. If it lasts longer, and the symptom pattern fits that characteristic of<unk> , the diagnosis may be changed. Obsessive compulsive disorder may be diagnosed for intrusive thoughts that are recurring but not related to a specific<unk>  event. In extreme cases of prolonged, repeated<unk> ation where there is no viable chance of escape, survivors may develop complex<unk> . This occurs as a result of layers of trauma rather than a single<unk>  event, and includes additional symptomatology, such as the loss of a coherent sense of self.
Post-traumatic stress disorder
Borderline personality disorder
Acute stress disorder
Dissociative disorder not otherwise specified
Adjustment disorder
Exploding head syndrome
Stress-related disorders
Hodophobia