Skip survey header

PTSD Checklist Civilian Version with reporting - v2

PTSD Checklist

INSTRUCTIONS: Below is a list of problems and complaints that people sometimes have in response to stressful experiences. Please read each one carefully, select the response that best describes how much you have been bothered by that problem in the past month. Also, depending on how you answer the questions, you may be asked to provide some additional details about what has been going on. ANSWERING THE QUESTIONS ASKING FOR DETAILS IS OPTIONAL. Some of these questions may not be relevant to your situation.
This question requires a valid date format of MM/DD/YYYY.
calendar
1.) Repeated, disturbing memories, thoughts, or images of a stressful experience? *This question is required.
2.) Repeated, disturbing dreams of a stressful experience from the past? *This question is required.
3.) Suddenly acting or feeling as if a stressful experience were happening again? * *This question is required.
4.) Feeling very upset when something reminded you of a stressful experience? *This question is required.
5.) Having physical reactions (e.g., heart pounding, trouble breathing, sweating) when something reminded you of a stressful experience? *This question is required.
6.) Avoiding thinking about or talking about a stressful experience or avoiding having feelings related to it? *This question is required.
7.) Avoiding activities or situations because they reminded you of a stressful experience? *This question is required.
8.) Trouble remembering important parts of a stressful experience? *This question is required.
9.) Loss of interest in activities that you used to enjoy? *This question is required.
10.) Feeling distant or cut off from other people? *This question is required.
11.) Feeling emotionally numb or being unable to have loving feelings for those close to you? *This question is required.
12.) Feeling as if your future will somehow be cut short? *This question is required.
13.) Trouble falling or staying asleep? *This question is required.
14.) Feeling irritable or having angry outbursts? *This question is required.
15.) Having difficulty concentrating? *This question is required.
16.) Being "super-alert" or watchful or on guard? *This question is required.
17.) Feeling jumpy or easily startled? *This question is required.