Which is NOT a core PTSD symptom cluster?

• A. Intrusion
• B. Avoidance
• C. Negative alterations in cognition/mood
• D. Mania

Answer: (D)

Understanding PTSD involves four main symptom clusters: intrusion (recurrent distressing memories or flashbacks), avoidance (efforts to avoid thoughts, feelings, or reminders of the trauma), negative alterations in cognition and mood (more pervasive negative beliefs, distorted blame, persistent negative emotional state, diminished interest, or detachment), and alterations in arousal and reactivity (irritability, hypervigilance, exaggerated startle, sleep disturbance). Mania, on the other hand, is a mood state characterized by elevated or expansive mood, increased energy, decreased need for sleep, racing thoughts, and impulsive or risky behavior, and it belongs to mood disorders like bipolar disorder, not PTSD. Since PTSD’s diagnosis hinges on those four clusters, mania does not fit as a PTSD symptom cluster. A person could experience mania separately, while their PTSD symptoms would be described by the intrusion, avoidance, negative cognitions/mood, and arousal/reactivity clusters.