The symptoms of PTSD are subjective, and they can overlap with other disorders and/or can represent a variant of a normal response such as anger. Thus, nightmares, as a symptom, are not sufficient criteria for the diagnosis of PTSD.
The patient can be someone who is very angry at his/her employer. Perhaps s/he feels that the robbery was an inside job. Perhaps s/he feels her employer did not provide sufficient security. S/he may blame the employer for how the robbery was handled and blame the police for not appearing more invested in apprehending the perpetrators.
Symptoms can be a very effective means of controlling other people. As soon as someone wants you to accept more responsibility, you present symptoms that make doing so quite impossible. You go from an employee who had no control in a robbery to one who now has total control over employer, coworkers, health care, insurer, family and even law enforcement. No one can do enough for you. This makes you very powerful where once you felt powerless.
What needs to be determined is the extent to which anger is a key factor in explaining a patient’s response to the event.
We become focused upon secondary gain (financial benefits, attention, affection, time off from work), but it is always important to consider whether the physical and emotional complaints are being used as though they are tools to solve complex problems.