Mental Health Assessment
This assessment is confidential, please answer all questions as truthfully as possible.
There is one question about the stressful experience or event, followed by 20 multiple-choice questions below.
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Have you ever had an extremely stressful experience may have many a range of different problems as a result of the stressful experience. Description of the specific, worst stressful experience you are holding in mind:
For each of the questions below, keep your worst experience or event in mind, please read each problem carefully and then select one response to indicate how much you have been bothered by that problem in the past month.
In the past month, how much were you bothered by:
Repeated, disturbing, and unwanted memories of the stressful experience?
Clear selection
Repeated, disturbing dreams of the stressful experience?
Clear selection
Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?
Clear selection
Feeling very upset when something reminded you of the stressful experience?
Clear selection
Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?
Clear selection
Avoiding memories, thoughts, or feelings related to the stressful experience?
Clear selection
Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?
Clear selection
Trouble remembering important parts of the stressful experience?
Clear selection
Having strong negative beliefs about yourself, other people, or the world(for example, having thoughts such as: l am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)?
Clear selection
Blaming yourself or someone else for the stressful experience or what happened after it?
Clear selection
Having strong negative feelings such as fear, horror, anger, guilt, or shame?
Clear selection
Loss of interest in activities that you used to enjoy?
Clear selection
Repeated, disturbing dreams of the stressful experience?
Clear selection
Feeling distant or cut off from other people?
Clear selection
Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?
Clear selection
Irritable behavior, angry outbursts, or acting aggressively?
Clear selection
Taking too many risks or doing things that could cause you harm?
Clear selection
Being "superalert" or watchful on guard
Clear selection
Feeling jumpy, or easily startled?
Clear selection
Having difficulty concentrating?
Clear selection
Trouble falling or staying asleep?
Clear selection
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