Which symptoms constitute the 'arousal and reactivity' criterion in PTSD?

• A. Only experience memory loss.
• B. Lack of emotional reactivity.
• C. Persistent mood elevation.
• D. Irritable or aggressive behavior; reckless or self-destructive behavior; hypervigilance; exaggerated startle response; problems with concentration; sleep disturbance.

Answer: (D)

The arousal and reactivity symptoms in PTSD refer to heightened physiological and emotional arousal after a trauma, not to memory loss or mood shifts. The set described includes irritability or aggressive outbursts, reckless or self-destructive behavior, hypervigilance, an exaggerated startle response, concentration difficulties, and sleep disturbance. These reflect the body's persistent readiness to react to potential danger and the ways that trauma can disrupt daily functioning.

This is why the option listing those exact symptoms is the best choice: it aligns with what the arousal and reactivity cluster captures—difficulties in regulating arousal, from sleep and concentration problems to cautious or defensive behaviors and heightened sensitivity to stimuli.

In contrast, memory loss is not an arousal symptom; lack of emotional reactivity points to emotional numbing rather than heightened arousal; and persistent mood elevation is not a PTSD arousal feature and resembles mood disorders like mania. Remember, PTSD arousal symptoms typically present in multiple domains (behavioral, cognitive, and physiological) and are distinct from intrusion, avoidance, or negative mood/cognition clusters.