Please complete this assessment if you have experienced a significantly upsetting, distressing, or frightening event, or heard that it happened to a close family member or friend.
Over the past month or longer, how often have you experienced or been concerned about any of the following?
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Almost Never
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Sometimes
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Often
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Very Often
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| 1: I have recurrent thoughts, images, flashbacks or dreams of the emotionally traumatic event |
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| 2: Minor triggers including sounds, places or images remind me of the event and cause distress |
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| 3: The change in my mood since the event is having a negative impact on certain aspects of my life, work or relationships |
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| 4: I consciously suppress thoughts, feelings or conversations about the event |
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| 5: I avoid places, situations, activities or people who may remind of the event |
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| 6: I have lost interest in or no longer derive pleasure from activities that I used to enjoy |
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| 7: I feel disconnected or emotionally detached from other people since the event |
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| 8: I feel numb and struggle with emotions such as affection, intimacy and tenderness |
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| 9: I am pessimistic about the future and battle to see the road ahead in a positive manner |
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| 10: I have had trouble falling or staying asleep since the event |
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| 11: I am irritable, short tempered and more prone to becoming angry since the event |
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| 12: I battle with my concentration and find it difficult to complete tasks |
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| 13: I feel tense, distrustful and have become overly aware of my surroundings, my health or other people |
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| 14: I am prone to emotional outbursts towards others that I find difficult to control |
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| 15: I feel anxious and find it difficult to relax |
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