PCL-5

**Your Worst Event:** A car accident that occurred two years ago. **In the past month, how much were you bothered by:** 1. **Repeated, disturbing, and unwanted memories of the stressful experience?** [ ] 0 - Not at all [ ] 1 - A little bit [ ] 2 - Moderately [x] 3 - Quite a bit [ ] 4 - Extremely 2. **Repeated, disturbing dreams of the stressful experience?** [ ] 0 - Not at all [x] 1 - A little bit [ ] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 3. **Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were back there reliving it)?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 4. **Feeling very upset when something reminded you of the stressful experience?** [ ] 0 - Not at all [ ] 1 - A little bit [ ] 2 - Moderately [x] 3 - Quite a bit [ ] 4 - Extremely 5. **Having strong physical reactions when something reminded you of the stressful experience (e.g., heart pounding, trouble breathing, sweating)?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 6. **Avoiding memories, thoughts, or feelings related to the stressful experience?** [ ] 0 - Not at all [ ] 1 - A little bit [ ] 2 - Moderately [x] 3 - Quite a bit [ ] 4 - Extremely 7. **Avoiding external reminders of the stressful experience (e.g., people, places, conversations, activities, objects, or situations)?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 8. **Trouble remembering important parts of the stressful experience?** [ ] 0 - Not at all [ ] 1 - A little bit [ ] 2 - Moderately [x] 3 - Quite a bit [ ] 4 - Extremely 9. **Having strong negative beliefs about yourself, other people, or the world (e.g., "I am bad," "No one can be trusted," "The world is completely dangerous")?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 10. **Blaming yourself or someone else for the stressful experience or its aftermath?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 11. **Having strong negative feelings such as fear, horror, anger, guilt, or shame?** [ ] 0 - Not at all [ ] 1 - A little bit [ ] 2 - Moderately [x] 3 - Quite a bit [ ] 4 - Extremely 12. **Loss of interest in activities that you used to enjoy?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 13. **Feeling distant or cut off from other people?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 14. **Trouble experiencing positive feelings (e.g., unable to feel happiness or have loving feelings)?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 15. **Irritable behavior, angry outbursts, or acting aggressively?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 16. **Taking too many risks or doing things that could cause you harm?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 17. **Being “superalert” or watchful or on guard?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 18. **Feeling jumpy or easily startled?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 19. **Having difficulty concentrating?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely 20. **Trouble falling or staying asleep?** [ ] 0 - Not at all [ ] 1 - A little bit [x] 2 - Moderately [ ] 3 - Quite a bit [ ] 4 - Extremely