Trauma / PTSD self-test

(In order to score yourself, please print the following test below
by clicking Ctrl+p (Cmd+p on mac) on your keyboard.)


Are you currently or have you ever experienced the following?

____Childhood Emotional/Verbal Abuse Childhood Physical Abuse

____Childhood Sexual Abuse

____Rape or Forced Sex

____War/Combat

____Violent Attack/assault

____Severe Car Accident

____Stalking or Harassment

____Kidnapping or Abduction

____Unexpected death of loved one

____Suicide or suicide attempt of loved one

____Spousal/relationship suddenly ending Divorce

____Earthquake

____House fire or loss of cherished possessions Flood, Tornado, Natural Disaster

____Death or severe injury of a child

____Witnessing Domestic Violence as Child Victim of Domestic Violence

____Adulthood Witnessing a traumatic or violent event Burglary/home invasion

____Work related harassment/trauma

____Diagnosis of Chronic or Terminal Illness Surgeries

____Plane Crash

____Workplace explosion, chemical spill, industrial accident

____Loss of home or financial security

____Psychological Abuse ____bullying

____humiliation

____withholding/ignoring

____Ridicule

____Cruelty

____Yelling/threats

____Overly demanding parent

____Death of parent

____Death of spouse or partner

____Death of close friend or family member

Other

____Missing loved one Near drowning

____Suicide attempt/self mutilation

____Sudden and unexplained estrangement from friend/family

____Torture

____Incarceration

____Physical Injury

____Murder of loved one

____Riots/Community violence

Initial Symptom Checklist for Post Traumatic Stress

Are you currently and/or have you recently experienced any of the following symptoms?

____FLASHBACKS

Intrusive recall of traumatic events in form of images, sounds, smells, and/or feelings related to traumatic

and painful experiences

____NIGHTMARES

Nightmares and dreaming about traumatic experiences, themes, or people reminiscent of painful

experiences

____HYPERVIGILENCE

Being “on guard” and intensely focused on environment; scanning, watching, expecting danger

____ISOLATION

Avoidance of activities, others, crowds, phone calls, new experiences

____SLEEP PROBLEMS

Describe_________________________________________________

____INCREASED USE OF DRUGS OR ALCOHOL

Attempts to numb painful feelings or symptoms

____INCREASED USE OF FOOD OR FOOD RESTRICTION

Attempts to numb painful feelings or symptoms

____STARTLE RESPONSE

Increased sensitivity to sights, sounds, movements/ “jumpy”

____ANXIETY

Nervous, restless, fearful, “butterflies”

____PANIC ATTACKS

Extreme unexplained fear, terror, heart palpitations, dizziness, fear of “going crazy”

____INABILITY TO DESCRIBE OR TALK ABOUT PAINFUL EXPERIENCES

____TRIGGER RESPONSES OR OVER-REACTIONS To events, sounds, smells etc reminiscent of traumas

____SPACING OUT,LOSING TIME FEELING ODD, STRANGE, OR DISCONNECTED

____DEPRESSION

____LACK OF ENERGY

____SUICIDAL THOUGHTS or ATTEMPTS

____MOOD SWINGS

____SELF MUTILATION (Cutting, burning, scratching)

____LACK OF TRUST/PARANOIA

____INABILITY TO “GET OVER” EVENTS OR HURTS

____HEARING VOICES, SEEING IMAGES OR SHADOWS

____OBSESSIVE THINKING AND RUMINATING

____HEARING VOICES, SEEING IMAGES OR SHADOWS

____FEELING NUMB OR DETACHED

 

How To Receive Help

You may call The Transformation Center and set up an appointment for a free assessment that will help you understand whether or not our program is appropriate for you. At that time you will be able to ask questions and express your possible fears or concerns about treatment. We will help you through every step along the way and encourage you that your healing and a better life is within reach. 901-755-1396.

Click PTSD Trauma Recovery Program for a detailed brochure.