Pseudo-Traumatic Confabulatory Syndrome

Pseudo-Traumatic Confabulatory Syndrome, also known as PTCS is a severe mental distress caused by false memories, those memories consist primarly of oneself being exposed to a threatening events despite it having not happened. It is a common symptom in Catathymia and Trementia in general.

## Symptoms

1. Presence of one (or more) of the following intrusion symptoms associated with the confabulated memory:
	1. Recurrent, involuntary, and intrusive distressing thoughts related to the memory. **Note:** In children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic event(s) are expressed.
	2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the memory. **Note:** In children, there may be frightening dreams without recognizable content.
	3. Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the confabulated event was recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) **Note:** In children, "trauma"-specific reenactment may occur in play.
	4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the memory.
	5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the memory.
2. Persistent avoidance of stimuli associated with the confabulated memory:
	1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the memory.
	2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the memory.
3. Negative alterations in cognitions and mood associated with the confabulated memory(ies):
	1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia, and not to other factors such as head injury, alcohol, or drugs).
	2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., “I am bad,” “No one can be trusted,” “The world is completely dangerous,” “My whole nervous system is permanently ruined”).
	3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
	4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
	5. Markedly diminished interest or participation in significant activities.
	6. Feelings of detachment or estrangement from others.
	7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
4. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
	1. Irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or physical aggression toward people or objects.
	2. Reckless or self-destructive behavior.
	3. Hypervigilance.
	4. Exaggerated startle response.
	5. Problems with concentration.
	6. Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).