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BodyBasedMindfulnessCourses.com
Body Based Mindfulness Courses Trauma Self-Test
93
Questions
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1
Dreams connected to traumatic events
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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2
Lack of memory – particularly in connection to trauma
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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3
Memories of traumatic events are fragmented
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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4
Feeling like you are re-experiencing the trauma
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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5
Difficulty concentrating or focusing
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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6
Clumsiness
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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7
Body feels unmovable, paralyzed, or stuck
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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8
Feeling helpless and/or powerless
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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9
Accident prone
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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10
Feeling out of control
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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11
Fear you will never feel "normal" again
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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12
Feeling disoriented and/or confused
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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13
Changes in sleep patterns
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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14
Chronic fatigue, low energy, physically drained
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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15
Intrusive thoughts or pictures randomly come to mind related to traumatic events
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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16
Easily overwhelmed
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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17
Feeling paranoid - i.e. people are watching you
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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18
Headaches or migraines
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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19
Waking up in a panic and/or night terrors
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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20
Easily startled
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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21
Extreme mood swings
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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22
Loss of self-confidence
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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23
Desire to leave or get away when uncomfortable
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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24
Excess energy, restlessness, can't relax
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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25
Feeling out of your body - i.e. watching yourself go through the motions
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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26
Feeling not real, and/or everything is surreal
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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27
Losing track of time, chronically late
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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28
Difficulty trusting
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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29
Panic attacks
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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30
Hypervigilance, i.e. always watching your back
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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31
Feeling like your body is heavy
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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32
Anxiety
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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33
Nausea and/or vomiting
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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34
Changes in appetite, i.e. eating too much or too little
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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35
Easily and frequently angered about trifles
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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36
Sudden uncontrolled anger or rage
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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37
Excessive worrying
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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38
Overly cautious
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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39
Chronic pain, seemingly unconnected to injury
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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40
Feeling alone, like no one understands
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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41
Isolating yourself and/or withdrawal from others
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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42
Suppressing your emotions
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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43
Difficulty recognizing options
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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44
Lack of interest in life
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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45
Strained relationships
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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46
Sudden fear for no reason
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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47
Desire for self-harm or to hurt others
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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48
Changes in sexual interest
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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49
Misplacing things, i.e. phone, keys, wallet/purse
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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50
Dizziness
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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51
Feeling like someone is controlling you or your mind
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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52
Don't want to be alone
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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53
Feeling unsafe around people
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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54
Easily tearful
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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55
Fear when going out or being in new places
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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56
Unable to cry
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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57
Feeling not good enough
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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58
Loss of interest in prior enjoyable activities
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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59
Oversensitive to noise and light
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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60
Feeling sad and depressed
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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61
Apathy, i.e. not caring
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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62
Lack of motivation to begin tasks
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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63
Not completing tasks
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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64
Feeling like life will be cut short
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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65
Feeling emotionally distant and cut off from people
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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66
Overly irritable
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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67
Constantly thinking about a traumatic event
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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68
Obsessing about what you would have done differently
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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69
Having to recheck what you have already done
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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70
Shame
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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71
Feeling like something bad is going to happen
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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72
Feeling like your body structure has no support, inner weakness
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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73
Shakiness
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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74
Guilt and/or regret
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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75
Indecision, i.e. can't make choices
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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76
Feeling sick to your stomach, upset stomach, feeling of knots, etc.
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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77
Body or parts of body feel numb
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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78
Feeling shut down
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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79
Not feeling safe
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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80
Self-critical
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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81
Feeling like you can't protect yourself and/or your loved ones
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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82
Feeling an excessively urgent need to finish something
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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83
Suppressing your emotions
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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84
Easily offended, emotionally oversensitive
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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85
Awareness of changes in heart rhythm, i.e. racing heart, arrythmia
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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86
Change in temperature sensitivity - hot, cold, chills, hot flashes
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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87
Becoming violent - throwing things, hitting, kicking, etc.
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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88
Overwhelming emotions coming all at once
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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89
Avoiding triggers
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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90
Distracted easily
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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91
Excessive or chronic muscle tension
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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92
Lack of normal fear
0 Never
1 Rarely
2 Sometimes
3 Often
4 Most Times
5 Always
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93
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