D. Persistent symptoms of arousal (not present before the trauma) (12) difficulty in falling or staying asleep Frequency In the past week, have you had any problems falling or staying asleep? Is this different from the way you were sleeping before the event? How often have you problems sleeping? Intensity (Ask probe questions and rate overall sleep disturbance) How long did it take you to fall asleep? How many times did you wake up in the night? How many hours total did you sleepeach night? 0 Never 1 Once 0 1 2 Two or three times 2 3 Four or five times 3 4 Nightly or almost everynight 4 SLEEP ONSET PROBLEMS? MID SLEEP WAKENING EARLY AM WAKENING (13) No sleep problems Mild, takes slightly longer to fall asleep, or minimal difficulty staying asleep (up to30 minutes loss of sleep) Moderate, definite sleep disturbance, with clearly longer latency to sleep or clear difficulty staying asleep (30 to 90 minutes loss of sleep) Severe, much longer latency to sleep ormarked difficulty staying asleep (90 to 180 minutes loss of sleep) Extreme, very long latency to sleep or profound difficulty staying asleep (greater than 180 minutes loss of sleep) Y N Y N Y N irritability or outbursts of anger Frequency In the past week, have there been times when you felt unusually irritable, or expressed feeelings of anger and acted aggressively? Is this different from how you felt or acted before the event? How often have felt or acted this way? Intensity How angry were you? In what ways did you express or show anger? 0 Never 1 Once 0 1 2 Two or three times 2 3 Four or five times 3 4 Daily or almost every day 4 No irritability or anger Mild, minimal irritability, raises voice when angry Moderate, irritability clearly present, easily becomes argumentative, but can recover quickly Severe, marked irritability, becomes verbally or physically aggressive when angry Extreme, pervasive anger, episodes of physical violence