Question |
Response |
1. |
Have you experienced or witnessed an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of yourself or others? |
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2. |
When this event happened, did you feel intense fear, helplessness, or horror? |
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3. |
Do you experience recurrent and intrusive distressing memories, images, or thoughts of the event? |
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4. |
Do you experience recurrent distressing dreams of the event? |
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5. |
Do you sometimes act or feel as if the event were happening again? |
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6. |
Do you feel very distressed or anxious when you see or hear something that reminds you of the event? |
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7. |
Do you get strong physical sensations of anxiety (like racing heart, rapid breathing, sweating) when you see or hear something that reminds you of the event? |
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8. |
Do you go out of your way to avoid thoughts, feelings, or conversations associated with the event? |
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9. |
Do you go out of your way to avoid activities, places, or people that arouse recollections of the event? |
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10. |
Are you unable to recall an important aspect of the event? |
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11. |
Have you lost interest in significant activities? |
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12. |
Do you feel detached or estranged from others? |
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13. |
Do you feel emotionally "numb", or like you are unable to feel certain feelings? |
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14. |
Do you have a sense that your future will be bleak or short? |
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15. |
Do you have difficulty falling or staying asleep? |
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16. |
Do you have irritability or outbursts of anger? |
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17. |
Do you have difficulty concentrating? |
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18. |
Are you constantly "on guard" or watchful for danger? |
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19. |
Are you "jumpy" or do you get startled easily? |
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20. |
Have you experienced these problems for more than one month? |
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21. |
Do these problems cause you to feel very distressed, anxious, or upset? |
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22. |
Do these problems impair your social, occupational, or other important areas of functioning? |
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