Is This Trauma? — Diagnosis Decision Tree
Trauma presentations are among the most frequently misidentified in outpatient therapy. This decision tree walks through the full differential — from Criterion A to PTSD, from small-t to complex — with specific clinical criteria and treatment implications for each.
What is in this decision tree
The Criterion A decision point — what qualifies as a traumatic event under DSM-5 and what happens clinically when the presentation is significant but does not meet formal criteria.
The timeline branch — acute stress response vs. Acute Stress Disorder vs. PTSD. What each looks like, when each is diagnosable, and what to do at each time point.
Full PTSD criteria (B, C, D, E) — the four criterion clusters in checklist format with symptom examples. Includes the dissociative specifier and delayed expression note.
Adjustment Disorder — criteria, subtypes, common stressors, and why it is often undertreated despite significant functional impact.
Small-t trauma framework — presentations that do not meet Criterion A but are clinically significant, with examples and the case for a trauma-informed approach regardless of formal diagnosis.
Complex trauma indicators — affect dysregulation, self-organization disturbances, relational patterns, and dissociation beyond PTSD. Why complex presentations require phase-based treatment.
Common misidentification table — the presentations that look like depression, anxiety, or personality issues but may actually be complex or developmental trauma, with clinical notes on each.
Pre-processing checklist — what needs to be in place before trauma processing work begins, regardless of diagnosis.