Directions: This inventory is for your benefit, so be as honest as you can in filling it out. We recommend you print this out to make the scoring easier. Place a number in the blank that precedes each statement to indicate how true that statement is for you.
(1= Almost Never, 2= Occasionally, 3= Frequently, and 4= Almost Always)
___1. Inside I feel like a tightly coiled spring.
___2. I have trouble falling asleep and staying asleep.
___3. I feel I have to “walk on egg shells.”
___4. I have trouble concentrating on what I am doing.
___5. I feel empty and alone.
___6. I feel like I am on an emotional roller-coaster.
___7. I have a hard time telling what I am feeling.
___8. I avoid certain kinds of places that remind me of events from my past.
___9. Certain smells, movements and/or behaviors can easily cause a reaction inside of me.
___10. I feel like a spectator to my life.
___11. I have reoccurring bad memories/dreams of my past.
___12. I over-react to certain kinds of people and/or in certain situations.
___13. I feel like other people are in charge of my life.
___14. My thoughts seem to have a life of their own.
___15. I feel like I have a huge black hole inside of me.
___16. When I think about my childhood I draw a blank.
___17. I experience periodic episodes of rage or of just “losing it.”
___18. I work best when I am under a lot of pressure.
___19. I have trouble paying attention to what others are saying.
___20. I am easily bored.
___21. I have trouble connecting with people.
___22. I organize my life around the avoidance of conflict.
___23. I have trouble keeping my weight down.
___24. I experience big gaps in memory when I think about my childhood.
___25. It’s hard for me to have positive thoughts about my future.
25 – 35 Your answers indicate that you may have very few PTSD symptoms
36 – 50 Your answers indicate that you may have some PTSD symptoms
51 – 100 Your answers indicate that you may have many PTSD symptoms