Which PTSD symptom cluster includes hyperarousal?

• A. Intrusion
• B. Avoidance
• C. Hyperarousal
• D. Negative alterations in mood and cognition

Answer: (C)

PTSD symptoms are grouped into four clusters, and hyperarousal is the one that collects symptoms reflecting heightened physiological arousal and a constant state of readiness for threat. This includes sleep disturbance, hypervigilance, an exaggerated startle response, irritability or angry outbursts, and difficulty concentrating. Because these signs center on being on edge and ready to react, they belong in the hyperarousal cluster. By contrast, intrusion covers reexperiencing distressing memories or nightmares, avoidance involves efforts to steer clear of reminders, and negative alterations in mood and cognition encompass persistent negative beliefs, detachment, and reduced ability to experience positive emotions. So when symptoms revolve around sleep problems, being easily startled, and irritability, they fit the hyperarousal cluster.