Changes

A traumatic experience is defined in DSM-IV as the direct consequence of experiencing or witnessing of serious injury or threat to physical integrity that produces intense fear, helplessness or (in the case of children) agitation (American Psychiatric Association, 1994). The significant pain and distress described earlier is consistent with this definition. Moreover, the disturbance (e.g., physiological arousal, avoidant behaviour) qualifies for a diagnosis of acute stress disorder if it lasts at least two days or even a diagnosis of post-traumatic stress disorder ([[PTSD]]) if it lasts more than a month. Circumcision without anaesthesia constitutes a severely traumatic event in a child's life.<ref name="boyle2002">{{REFjournal |last=Boyle |first=Gregory J. |init=GJ |author-link=Gregory J. Boyle |last2=Goldman |first2=Ronald |init2=R |author2-link=Ronald Goldman |last3=Svoboda |first3=J. Steven |init3=JS |author3-link=J. Steven Svoboda |last4=Fernandez |first4=Ephrem |init4=E |author4-link= |etal=no |title=Male circumcision: pain, trauma and psychosexual sequelae |journal= J Health Psychology |location= |date=BoyleGJ GoldmanR SvobodaJS FernandezE 2002-05-01 |volume=7 |issue=3 |pages=329-43 |url=http://www.cirp.org/library/psych/boyle6/ |quote= |pubmedID=22114254 |pubmedCID= |DOI=10.1177/135910530200700310 |accessdate=2019-12-10}}</ref>