SELF TEST for ADULT TRAUMA RESPONSE  
 
Read more about Adult Trauma Response
Please provide us with your gender.
Gender : Male Female  
 
1. Have your sleeping patterns been affected by the recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
2. Do you have bad dreams or nightmares related to recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
3. Have you been told by others that your alcohol and /or drug use has increased with recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
4. Did you lose family or a friend in a recent violent episode?
 
Yes
No
   
5. Are you experiencing memory lapses since recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
6. Do you find it difficult to maintain healthy eating patterns since recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
7. Do you live close to any of the recent violent events sites?
 
Yes
No
   
8. Do you find it difficult to concentrate or stay focused on work or house duties since the violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
9. Do you feel tired or less motivated since recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
10. Are you often angry due to recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
11. Do you find yourself avoiding the media coverage related to recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
12. Due to the frequency or recent violent events, are you finding it difficult to go into urban areas or where large groups of people meet?
 
Constantly
Often
Sometimes
Rarely
Never
   
13. Are you having difficult traveling across bridges, going into elevators, going into tall buildings, or using mass transportation?
 
Constantly
Often
Sometimes
Rarely
Never
   
14. Does watching or reading about recent violent events make you agitated or depressed?
 
Constantly
Often
Sometimes
Rarely
Never
   
15. Are you noticing a decreased desire for intimacy since recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
16. Have you had more colds and/or mild medical conditions since recent violent attacks?
 
Constantly
Often
Sometimes
Rarely
Never
   
17. Have you been frequenting more healthcare providers since recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
18. Are you having panic/anxiety attacks that you can't control since recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
19. Have you suffered from more stomachaches, indigestion, or heartburn since recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
20. Is the fear that there will be more violent events causing you anxiety?
 
Constantly
Often
Sometimes
Rarely
Never
   
21. Do you feel hopeless about the future and helpless to change the future?
 
Constantly
Often
Sometimes
Rarely
Never
   
22. Do you find yourself weeping more or having difficulty staying optimistic?
 
Constantly
Often
Sometimes
Rarely
Never
   
23. Have you had flashbacks or intrusive thoughts of explosions, plane crashes or violence?
 
Constantly
Often
Sometimes
Rarely
Never
   
24. Do you find yourself spending more time alone and less time in social settings?
 
Constantly
Often
Sometimes
Rarely
Never
   
25. Do you find yourself being easily startled?
 
Constantly
Often
Sometimes
Rarely
Never
   
26. Have friends or family members mentioned recently that you are acting differently?
 
Constantly
Often
Sometimes
Rarely
Never
   
27. Have your employer or coworkers confronted you about your work habits or actions on the job?
 
Constantly
Often
Sometimes
Rarely
Never
   
28. Have you become fearful of traveling to certain locales because of recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
29. Have you procrastinated on making major decisions since recent violent attacks?
 
Constantly
Often
Sometimes
Rarely
Never
   
30. Have you suffered more headaches, body pains, or muscle tension since recent violent events?
 
Constantly
Often
Sometimes
Rarely
Never
   
 
 
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