Screening for Posttraumatic Stress Disorder (PTSD)

If you suspect that you might suffer from PTSD, answer the questions below, print out the results and share them with your health care professional.

Are you troubled by the following?

Yes     No You have experienced or witnessed a life-threatening event that caused intense fear, helplessness, or horror.

Do you re-experience the event in at least one of the following ways?

Yes   No Repeated, distressing memories, or dreams
Yes   No Acting or feeling as if the event were happening again (flashbacks or a sense of reliving it)
Yes   No Intense physical and/or emotional distress when you are exposed to things that remind you of the event

Do reminders of the event affect you in at least three of the following ways?

Yes   No Avoiding thoughts, feelings, or conversations about it
Yes   No Avoiding activities and places or people who remind you of it
Yes   No Blanking on important parts of it
Yes   No Losing interest in significant activities of your life
Yes   No Feeling detached from other people
Yes   No Feeling your range of emotions is restricted
Yes   No Sensing that your future has shrunk (for example, you don't expect to have a career, marriage, children, or normal life span)

Are you troubled by at least two of the following?

Yes   No Problems sleeping
Yes   No Irritability or outbursts of anger
Yes   No Problems concentrating
Yes   No Feeling "on guard"
Yes   No An exaggerated startle response

Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Depression and substance abuse are among the conditions that occasionally complicate PTSD and other anxiety disorders.

Yes   No Have you experienced changes in sleeping or eating habits?

More days than not, do you feel…

Yes   No sad or depressed?
Yes   No disinterested in life?
Yes   No worthless or guilty?

During the last year, has the use of alcohol or drugs...

Yes   No resulted in your failure to fulfill responsibilities with work, school, or family?
Yes   No placed you in a dangerous situation, such as driving a car under the influence?
Yes   No gotten you arrested?
Yes   No continued despite causing problems for you or your loved ones?

Reference:
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994.

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