1 - Have you assisted or participated to a dramatic and disturbing event in you life?
Yes || No


During the last month:

2 - Have you been tense, agitated and irritable?
Never || Sometimes || Frequently

3 - Have you experienced a sensation of detachment from other people, from objects and from your usual activities?
Never || Sometimes || Frequently

4 - Have you experienced unpleasant, intrusive and uncontrollable thoughts?
Never || Sometimes || Frequently

5 - Have you experienced a lowered range of emotions?
Frequently || Sometimes || Never

6 - Have you had the sensation of living a terrible experience again?
Never || Sometimes || Frequently

7 - Have you had nightmares about that experience?
Never || Sometimes || Frequently

8 - Have you experienced a strong emotional and physical distress when something or someone made you recall that terrible event?
Frequently || Sometimes || Never

9 - Have you been avoiding places, situations or people that made you remember that experience?
Never || Sometimes || Frequently

10 - Have you been incapable of remembering some details of that experience?
Frequently || Sometimes || Never

11 - Have you experienced a lower involvement in your usual hobbies and recreational activities?
Frequently || Sometimes || Never

12 - Have you experienced an incapacity to remember some important information about your traumatic experience?
Frequently || Sometimes || Never

13 - Have you thought that your life is ruined forever and that it will never be the same again?
Frequently || Sometimes || Never

14 - Have you experienced sleep problems?
Frequently || Sometimes || Never

15 - Have you experienced difficulties in concentrating (even in very simple activities)?
Frequently || Sometimes || Never