Which of the following is NOT a category of PTSD?

• A. Hallucinations
• B. Intrusion
• C. Avoidance
• D. Alterations in arousal and reactivity

Answer: (A)

Hallucinations are not part of PTSD’s diagnostic symptom groups. PTSD is organized into four main symptom clusters: intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. Intrusion means re-experiencing the trauma through distressing memories, nightmares, or flashbacks. Avoidance involves steering clear of reminders of the trauma. Negative alterations in cognitions and mood cover persistent negative beliefs, distorted blame, diminished interest in activities, and emotional numbness. Alterations in arousal and reactivity include hypervigilance, an exaggerated startle response, concentration problems, and sleep disturbances.

Hallucinations—hearing or seeing things that aren’t there—are typically associated with psychotic disorders or substance-related conditions, not with PTSD. If such symptoms appear, they warrant assessment for other diagnoses or comorbidities. There is a PTSD specifier for dissociative symptoms like depersonalization or derealization, but that does not include true hallucinations and points to a different pattern of symptoms within PTSD.