Frequency
In the past week, have you
become upset when you were
exposed to things that remind of the event?
(For example, males for rape victims, sounds
of helicopters for war victims) How often?
Intensity At its worst, how much distress or
discomfort did exposure to these reminders
cause you?
0
1
2
Never
Once
Two or three times
0
1
2
3
4
Four or five times
Daily or almost daily
3
4
None
Mild, minimal distress
Moderate, distress clearly present,
but still manageable
Severe, incapacitating distress
Extreme, incapacitating
(3) sudden acting or feeling as if the traumatic event were recurring(includes a sense of
reliving the experience, illusions, hallucinations, and dissociative/flashback episodes,
even those that occur upon awakening or when intoxicated)
Frequency In the past week, have you acted
or felt as if the event was happening again?
How often?
Intensity At its worst, how much did it seem
that the event was happening again? How
long did it last? What did you do while this
was happening?
0
1
Never
Once
0
1
2
Two or three times
2
3
Four or five times
3
but
4
Daily or almost every day
retained some awareness of
surroundings
4
Extreme, complete dissociation, no
awareness of surroundings, possible
amnesia for the episode
(4)
recurrent distressing dreams of the event
Frequency
In the past week, have you had unpleasant
dreams of the event? How often?
Not at all
Mild, more realistic than just thinking
about the event
Moderate,definite but transient
dissociative quality;still aware of
surroundings
Severe, strongly dissociative quality,
Intensity
At their worst, how much distress did these
dreams cause you? Did they wake you up?
What were you feeling when woke up? How
long does it take you to get back to sleep?
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