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1.
Do you sometimes feel like you are re-living the event or that it is happening all over again?
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2.
Do you have recurrent nightmares or distressing dreams about the traumatic event?
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3.
Do you feel intense distress when something reminds you of the traumatic event, whether it’s something you think about or something in you see?
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4.
Do you try to avoid thoughts, feelings, or conversations that remind you of the traumatic event?
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5.
Do you try to avoid activities, people, or places that remind you of the traumatic event?
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6.
Are you unable to remember something important about the traumatic event?
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7.
Since the trauma took place, do you feel less interested in activities or hobbies that you once enjoyed?
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8.
Since the trauma took place, do you feel distant from other people or have difficulty trusting them?
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9.
Since the trauma took place, do you have difficulty experiencing or showing emotions?
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10.
Do you feel that your future will not be “normal” — that you won’t have a career, marriage, children, or a normal life span?
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11.
Since the traumatic event, have you had difficulty falling or staying asleep?
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12.
Have you felt irritable or have you had outbursts of anger?
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13.
Have you had difficulty concentrating, since the trauma?
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14.
Do you feel guilty because others died or were hurt during the traumatic event but you survived it?
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15.
Do you often feel jumpy or startle easily?
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16.
Do you often feel hypervigilant, that is, are you constantly feeling and acting ready for any kind of threat?
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17.
Have you been experiencing symptoms for more than one month?
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18.
Do your symptoms interfere with normal routines, work or school, or social activities?
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19.
Do you regularly experience intrusive thoughts or images about the traumatic event?
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20.
Have you experienced or been exposed to a traumatic event?
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21.
During the traumatic event, did you experience or witness serious injury or death, or the threat of injury or death?
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22.
During the traumatic event did you feel intense fear, helplessness, and/or horror?
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