PTSD Test

Name*

First NameLast Name

Please select your last evaluation date.*

Date

1. Any reminder brought back feelings about the event/s*

	0	1	2	3	4

0 is Disagree, 4 is Agree

2. I had trouble staying asleep*

	0	1	2	3	4

0 is Disagree, 4 is Agree

3. Other things kept making me think about it*

	0	1	2	3	4

0 is Disagree, 4 is Agree

4. I felt irritable and angry*

	0	1	2	3	4

0 is Disagree, 4 is Agree

5. I avoided letting myself get upset when I thought about it or was reminded of it*

	0	1	2	3	4

0 is Disagree, 4 is Agree

6. I thought about the event when I didn't mean to*

	0	1	2	3	4

0 is Disagree, 4 is Agree

7. I felt as if the event hadn't happened or it wasn't real*

	0	1	2	3	4

0 is Disagree, 4 is Agree

8. I have stayed away from reminders about the situation*

	0	1	2	3	4

0 is Disagree, 4 is Agree

9. Images and pictures of the event pop into my mind*

	0	1	2	3	4

0 is Disagree, 4 is Agree

10. I have been jumpy and easily startled*

	0	1	2	3	4

0 is Disagree, 4 is Agree

11. I have tried not to think about the situation*

	0	1	2	3	4

0 is Disagree, 4 is Agree

12. I am aware I have a lot of feelings about what happened but I haven’t dealt with them*

	0	1	2	3	4

0 is Disagree, 4 is Agree

13. I feel quite ‘numb’ about the situation*

	0	1	2	3	4

0 is Disagree, 4 is Agree

14. I have found myself acting / feeling like I am back at the time of the event*

	0	1	2	3	4

0 is Disagree, 4 is Agree

15. I have had trouble falling asleep*

	0	1	2	3	4

0 is Disagree, 4 is Agree

16. I experience waves of strong feelings about the situation*

	0	1	2	3	4

0 is Disagree, 4 is Agree

17. I have tried to remove the situation from my memory*

	0	1	2	3	4

0 is Disagree, 4 is Agree

18. I have trouble concentrating on things I am supposed to do*

	0	1	2	3	4

0 is Disagree, 4 is Agree

19. Reminder of the event cause me to have physical reactions such as sweating, palpitations, panic attacks*

	0	1	2	3	4

0 is Disagree, 4 is Agree

20. I have dreams about the situation*

	0	1	2	3	4

0 is Disagree, 4 is Agree

21. I feel on-guard and struggle to relax*

	0	1	2	3	4

0 is Disagree, 4 is Agree

22. I try not to talk about the situation*

	0	1	2	3	4

0 is Disagree, 4 is Agree

Calculation

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