“National Center for PTSD | Screening Questionnaire”
Instructions: Below is a list of problems that people sometimes have in response to a very stressful experience. Keeping your worst event in mind, please read each problem carefully and then select one of the numbers to the right to indicate how much you have been bothered by that problem in the past month.
Your worst event:
surviving
In the past month, how much were you bothered by the following:
Repeated, disturbing, and unwanted memories of the stressful event?
i’ve lied about my first kiss to every person i’ve ever met,
i will keep lying now.
i blacked out for a week when i was fourteen,
from anger? or grief? no,
gratitude.
i tried to swallow a bottle of migraine medicine,
and got caught by the sunrise.
Repeated, disturbing dreams of the stressful experience?
there is a gun in a mouth,
a wailing woman,
there is a text message,
i wake up most nights
afraid and exhausted.
Suddenly feeling or acting as if the experience were actually happening again?
i burst into tears, frequently
and disappoint everyone
when i can’t explain why.
Feeling very upset when something reminds you of the stressful experience?
9.911
Having strong physical reactions when something reminded you of the stressful experience?
i saw two ghosts on the side of the road
one living, one dead, both smiling
why so serious? they asked.
i was so afraid i pulled over
and threw up on the pavement.
Avoiding memories, thoughts, or feelings related to the stressful experience?
my palms ache from the nails i’ve dug into them.
Trouble remembering the stressful experience?
i’ve dived into a shallow kiddie pool
of nothingness
and cracked my skull on the bottom
Having strong negative beliefs about yourself, other people, or the world?
“monster buried in the body of a young girl”
Blaming yourself or someone else for the experience or what happened after it?
yes.
Having strong negative feelings such as fear, horror, anger, guilt, or shame?
i’m horrified
and angry
and guilty
and relieved.
Loss of interest in activities you used to enjoy?
i’ve lost my affinity for breathing,
i recall that i was pretty fond of it before.
Feeling distant or cut off from other people?
my heartbeat pounds
a bit too loudly
and distracts me
from fully engaging
with anything
Trouble experiencing positive feelings?
everyone who says they love me is a brilliant liar
Irritable behavior, angry outbursts, or acting aggressively?
when i enter a messy room
i feel ready to explode
and watch as my blood drips down
the walls
Taking too many risks or doing things that can cause you harm?
i knew it was a problem
when i was lying to everyone
about how the weight was coming off
Being “superalert” or watchful or on guard?
last week in the supermarket
there was a girl
arguing with her boyfriend
about bacon
and i was afraid
of the noise
Feeling jumpy or easily startled?
that predates the problem
Having difficulty concentrating?
i only write poems, anything longer and...
Trouble falling or staying asleep?
i’m so exhausted i no longer know if i’m asleep
or just staring a little too far off into the distance.
