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	Strongly Agree	Agree	Somewhat Agree Somewhat Disagree	Disagree	Strongly Disagree
1. The traumatic event that I experienced made me question whether I would live or die.
2. I experience inexpressible feelings of fear.
3. I still can't believe what happened to me.
4. I blame myself for what happened.
5. I have memories from my experience that continually play in my mind.
6. I have nightmares as a result of my experience.
7. Anything that reminds me of what happened triggers a lot of fear inside of me.
8. I do everything I can to distract myself from things that remind me of what happened.
9. I try to avoid anything that reminds me of my experience.
10. There are things I cannot recall about my trauma.
11. Since my experience, I don't find joy in things that used to be fun to me.
12. This experience has made me feel like I am completely alone.
13. I feel a strong desire to love the people around me as a result of my experience.
14. I have had suicidal thoughts due to this experience.
15. I believe that sometime in the future something good can come from my experience.
16. Since this experience I have had a difficult time sleeping.
17. I experience a lot of muscle tension.
18. For no apparent reason I feel like my heart is going to jump out of my chest.
19. I find that I get easily irritated since this happened.
20. Even though I have experienced something difficult, I feel calm.
21. It is hard for me to focus on what is happening around me.
22. I feel threatened by the most basic things.
23. Surprisingly, I am at ease with what happened.
24. Many of the symptoms listed in this evaluation have been occurring for more than a month.
25. My experience has prevented me from participating in work and/or social events.

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