THIS QUESTIONNAIRE asks about problems you may have had after a very stressful experience involving actual or threatened death, serious injury, or sexual violence. It could be something that happened to you directly, something you witnessed, or something you learned happened to a close family member or close friend. Some examples are a serious accident, fire, disaster (e.g., hurricane, tornado, or earthquake), physical or sexual attack or abuse, war, homicide, or suicide.

BELOW IS A LIST OF PROBLEMS that people sometimes have in response to a very stressful experience. Keeping your worst event in mind, please read each problem carefully and indicate how much you have been bothered by that problem in the past month.

In the past month, how much were you bothered by: Never Occasionally Half of The Time Most of The Time All of The Time
1. Repeated, disturbing, and unwanted memories of the stressful experience
2. Repeated, distrubing dreams of the stressful experience
3. Suddenly feeling or acting as if the stressful experience were actually happening again (i.e. as if you were actually reliving it)
4. Feeling very upset when something reminded you of the stressful experience
5. Having strong physical reaction when something reminded you of the stressful experience (e.g. heart pounding, trouble breathing, sweating)
6. Avoiding memories, thoughts, or feelings related to the stressful experience
7. Avoiding external reminders of the stressful experience (e.g. people, places, conversations, activities, objects, or situations)
8. Trouble remembering important parts of the stressful experience
9. Having strong negative beliefs about yourself, other people, or the world (i.e. having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is ocmpletely dangerous)
10. Blaming yourself or someone else for the stressful experience or what happened after it
11. Having strong negative feelings such as fear, horror, anger, guilt, or shame
12. Loss of interest in activities that you used to enjoy
13. Feeling distant or cut off from other people
14. Trouble experiencing positive feelings (e.g., being unable to feel happiness or have loving feelings for people close to you)
15. Irritable behavior, angry outbursts, or acting aggressively
16. Taking too many risks or doing things that could cause you harm
17. Being “super-alert” or watchful or on guard
18. Feeling jumpy or easily startled
19. Having difficulty concentrating
20. Trouble falling or staying asleep