Trauma Questionnaire

Birthday*

Gender

Would you like your results?

Repeated, disturbing, and unwanted memories of the stressful experience?*

Repeated, disturbing dreams of the stressful experience?*

Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?*

Feeling very upset when something reminded you of the stressful experience? *

Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?*

Avoiding memories, thoughts, or feelings related to the stressful experience? *

Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?*

Trouble remembering important parts of the stressful experience?*

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)?*

Blaming yourself or someone else for the stressful experience or what happened after it? *

Having strong negative feelings such as fear, horror, anger, guilt, or shame? *

Loss of interest in activities that you used to enjoy? *

Feeling distant or cut off from other people?*

Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?*

Irritable behavior, angry outbursts, or acting aggressively? *

Taking too many risks or doing things that could cause you harm? *

Being “superalert” or watchful or on guard?*

Feeling jumpy or easily startled? *

Having difficulty concentrating?*

Trouble falling or staying asleep? *