In the past month, how much were you bothered by: | Not at all | A little bit | Moderately | Quite a bit | Extremely |
1. Repeated, disturbing, and unwanted memories of the stressful experience? | 0 | 1 | 2 | 3 | 4 |
2. Repeated, disturbing dreams of the stressful experience? | 0 | 1 | 2 | 3 | 4 |
3. Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)? | 0 | 1 | 2 | 3 | 4 |
4. Feeling very upset when something reminded you of the stressful experience? | 0 | 1 | 2 | 3 | 4 |
5. Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)? | 0 | 1 | 2 | 3 | 4 |
6. Avoiding memories, thoughts, or feelings related to the stressful experience? | 0 | 1 | 2 | 3 | 4 |
7. Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)? | 0 | 1 | 2 | 3 | 4 |
8. Trouble remembering important parts of the stressful experience? | 0 | 1 | 2 | 3 | 4 |
9. Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)? | 0 | 1 | 2 | 3 | 4 |
10. Blaming yourself or someone else for the stressful experience or what happened after it? | 0 | 1 | 2 | 3 | 4 |
11. Having strong negative feelings such as fear, horror, anger, guilt, or shame? | 0 | 1 | 2 | 3 | 4 |
12. Loss of interest in activities that you used to enjoy? | 0 | 1 | 2 | 3 | 4 |
13. Feeling distant or cut off from other people? | 0 | 1 | 2 | 3 | 4 |
14. Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)? | 0 | 1 | 2 | 3 | 4 |
15. Irritable behavior, angry outbursts, or acting aggressively? | 0 | 1 | 2 | 3 | 4 |
16. Taking too many risks or doing things that could cause you harm? | 0 | 1 | 2 | 3 | 4 |
17. Being "superalert" or watchful or on guard? | 0 | 1 | 2 | 3 | 4 |
18. Feeling jumpy or easily startled? | 0 | 1 | 2 | 3 | 4 |
19. Having difficulty concentrating? | 0 | 1 | 2 | 3 | 4 |
20. Trouble falling or staying asleep? | 0 | 1 | 2 | 3 | 4 |
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