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Women typically have higher PTSD rates than men in community settings (e.g., Pynoos et al., 2010 ) and in clinical populations (e., Conrad et al., 2010 ). But the higher frequency of women experiencing trauma over their lifetimes may be related to the fact that women suffer a greater proportion of lifetime abuse than men do (Lancet, 2011 ; Pynoos et al. Women also tend to make strong decisions about how to respond to their trauma; in community samples, women are more likely than men to report that they have sought help for trauma (Wang et al., 2009 ), and in veteran populations, women are more likely than men to use mental health services (Kilpatrick et al., 2012 ). Multiple other factors, such as the type of trauma women experience, their need for and tolerance of intimacy, and their cultural perspectives about trauma, place women at risk for more severe consequences than men of trauma exposure (Tagin, 2012 ).
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DSM-IV establishes a diagnosis of PTSD using the DSM-IV diagnostic criteria, whereas the DSM-5 proposed a substantial revision of the PTSD diagnosis and associated diagnostic criteria, as well as a number of other changes to the DSM framework. These revisions are based on several studies investigating the structural validity of the DSM-IV PTSD diagnosis as compared with other disorders with similar symptom patterns ( Gu et al., 2008 ; Nezu et al., 2012 ; Nezu, Nezu, Lee, & Yeh, 2009 ), as well as internalization of these symptom patterns by individuals with other psychiatric and nonpsychiatric disorders ( Nezu, Nezu, Seifer, & Yeh, 2011 ).
DSM-IV PTSD diagnostic criteria include four required symptoms and four related but not required symptoms. Four of these criteria reflect traumatic stress reactions (criterion A); the remaining four indicate behavioral symptoms consistent with PTSD (criterion B). In DSM-5, the four trauma-related criteria have been revised in three ways: (1) They are now required in all cases; (2) the duration of the disturbance is increased from 1 month to 1 year; and (3) the disturbance no longer has to be related to a single (single trauma) stressor. Two additional PTSD symptoms are now required, both of which assess avoidance-related symptoms (criterion C). The DSM-5 also establishes a new criterion D, which requires that symptoms of arousal must be present during the traumatic event, in addition to being present for at least 1 month, 2 months, or 3 months after the traumatic event.
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