PTSD Survey.Please answer all items. Your answers will be e-mailed to Karin Kramer and kept confidential. Your ID Number (as assigned by Karin) I've experienced or witnessed a terrible, horrific traumatic event such as sexual assault, murder, serious injury, torture, or a threat to my life or someone else's life. Not at all true Slightly true Moderately true Very true Completely true I've learned that a traumatic or violent event occurred to a close friend or family member. Not at all true Slightly true Moderately true Very true Completely true I've been repeatedly exposed to a traumatic or violent event. Not at all true Slightly true Moderately true Very true Completely true Upsetting memories of the traumatic event come into my mind over and over. Not at all true Slightly true Moderately true Very true Completely true I have upsetting dreams about the traumatic event. Not at all true Slightly true Moderately true Very true Completely true I sometimes have flashbacks and feel like the event is happening again. Not at all true Slightly true Moderately true Very true Completely true I get upset whenever I think about the event or whenever I'm reminded of it. Not at all true Slightly true Moderately true Very true Completely true I try to avoid upsetting thoughts, feelings, or memories of the traumatic event. Not at all true Slightly true Moderately true Very true Completely true I try to avoid people, places, objects, conversations, or situations that remind me of the event. Not at all true Slightly true Moderately true Very true Completely true I've lost interest in life. Not at all true Slightly true Moderately true Very true Completely true I often feel isolated or alienated from people. Not at all true Slightly true Moderately true Very true Completely true I feel numb and unable to experience love, pleasure, or happiness. Not at all true Slightly true Moderately true Very true Completely true I often feel like I have no future. Not at all true Slightly true Moderately true Very true Completely true How many months or years have you been having these symptoms (just take your best guess)? Have you been bothered by these kinds of memories, upsetting feelings, and symptoms during the past month? No Maybe Yes Thank you!
