Have you ever been exposed to actual or threatened death, serious injury, or sexual violence in one or more of the following ways?

1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it occurred to others.
3. Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of family member or friend, the event(s) must have been violent or accidental.
4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse) – (these cannot apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related).

Have you experienced one or more of the following intrusive symptoms associated with traumatic event(s) and for the duration of at least a month?

1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s).
2. Recurrent distressing dreams in which the content and/or effect of the dream are related to the traumatic event(s).
3. Dissociative reactions (i.e. flashbacks) in which you feel or act as if the traumatic event(s) were recurring. (Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.)
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

Do you persistent avoid the stimuli associated with the traumatic event(s) as evidenced by one of following:

• Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
• Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

Have you experienced negative changes in brain functions and mood, that are associated with the traumatic event(s), which begun or worsened after the traumatic event(s) occurred, as follows?

• Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
• Persistent and exaggerated negative beliefs or expectations about yourself, others, or the world (i.e. “I am bad;” “No one can be trusted;” “The world is completely dangerous;” “My whole nervous system is permanently ruined”).
• Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead you to blame yourself or others.
• Persistent negative emotion state (i.e. fear, horror, anger, guilt, or shame).
• Significantly diminished interest, or participation in activities that are/were important (to you).
• Feelings of detachment or estrangement from others.
• Persistent inability to experience positive emotions (i.e. inability to experience happiness, satisfaction, or loving feelings).

Have you experienced significant changes in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by the following symptoms?

• Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression towards people or objects.
• Reckless or self-destructive behavior.
• Hypervigilance.
• Exaggerated startle response.
• Problems with concentration.
• Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).

Have these symptoms lasted more than a month?

Have these symptoms created serious problems in your social and daily life?

Do you believe your symptoms are NOT caused by the physiological effects of a substance (i.e. drugs, alcohol, or a prescribed medication), or another medical condition?