Post-Traumatic Disorder Self-Test
Post-Traumatic Disorder Self-Test
If you suspect that you may suffer from Post-Traumatic Stress Disorder (PTSD), complete the self-test form below. Simply circle either 'YES' or 'NO' in answer to the questions. When you have completed the test, print the page and show the results to your Doctor, who will be able to help you.
1. Have you experienced or witnessed a life-threatening event that caused intense fear, helplessness or horror? This includes sexual abuse. YES/NO
2. Do you re-experience the event in at least one of the following ways?
2.1. Repeated, distressing memories and/or dreams? YES/NO
2.2. Acting or feeling as if the event was happening again? (flashbacks or re-living it). YES/NO
2.3. Intense physical and/or emotional distress when you are exposed to things that remind you of the event? YES/NO
3. Do you avoid reminders of the event and feel numb, compared to the way you felt before? YES/NO
4. Do you avoid thoughts, feelings and conversations about the event? YES/NO
5. Do you avoid activities, places or people who remind you of it? YES/NO
6. Have you blanked on parts of the detail? YES/NO
7. Are you losing interest in significant activities in your life? YES/NO
8. Are you feeling detached from other people? YES/NO
9. Do you feel as if your range of emotions is restricted? YES/NO
10. Do you feel as if your future is diminished in terms of marriage, children or a normal life span? YES/NO
11. Are you troubled by two or more of the following:
11.1. Problems sleeping? YES/NO
11.2. Irritability or outbursts of anger? YES/NO
11.3. Problems concentrating? YES/NO
11.4. Feeling 'on-guard'? YES/NO
11.5. An exaggerated startle response? YES/NO
12. Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Illness that sometimes complicate an anxiety disorder include depression and substance abuse. With this in mind, please take a moment to answer the following:
13. Have you experienced changes in sleeping or eating habits? YES/NO
14. More days than not, do you feel:
14.1. Sad or Depressed? YES/NO
14.2. Disinterested in life? YES/NO
14.3. Worthless or guilty? YES/NO
15. During the last year, has the use of alcohol or drugs:
15.1. Resulted in your failure to fulfill responsibilities with work, school or family? YES/NO
15.2. Placed you in a dangerous situation, such as driving a car under the influence? YES/NO
15.3. Been responsible for you being arrested? YES/NO
15.4. Continued despite causing problems for you and your loved ones? YES/NO
Reference: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Washington DC, American Psychiatric Association.
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The truth will set you free
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