If you already have an account, please log in here to continue.

Adult – PTSD – (Post-Traumatic Stress Disorder)

Below is a list of problems and complaints that people sometimes have in response to stressful experiences. Please read each one carefully. Circle the response that indicates how much you have been bothered by that problem in the past month
This field is hidden when viewing the form
This field is hidden when viewing the form
1. Repeated, disturbing memories, thoughts, or images of a stressful experience?(Required)
2. Repeated, disturbing dreams of a stressful experience?(Required)
3. Suddenly acting or feeling as if a stressful experience were happening again (as if you were reliving it)?(Required)
4. Feeling very upset when something reminded you of a stressful experience?(Required)
5. Having physical reactions (e.g., heart pounding, trouble breathing, sweating) when something reminded you of a stressful experience?(Required)
6. Avoiding thinking about or talking about a stressful experience or avoiding having feelings related to it?(Required)
7. Avoiding activities or situations because they reminded you of a stressful experience?(Required)
8. Trouble remembering important parts of a stressful experience?(Required)
9. Loss of interest in activities that you used to enjoy?(Required)
10. Feeling distant or cut off from other people?(Required)
11. Feeling emotionally numb or being unable to have loving feelings for those close to you?(Required)
12. Feeling as if your future will somehow be cut short?(Required)
13. Trouble falling or staying asleep?(Required)
14. Feeling irritable or having angry outbursts?(Required)
15. Having difficulty concentrating?(Required)
16. Being super-alert or watchful or on guard?(Required)
17. Feeling jumpy or easily startled?(Required)
Name
Password
This field is hidden when viewing the form
This field is for validation purposes and should be left unchanged.

If you already have an account, please log in here to continue.