Trauma Screening Questionnaire printable pdf download

Trauma Screening Questionnaire

Appendices

N: T

(TSQ)

PPENDIX

RAUMA

CREENING

UESTIONNAIRE

Please consider the following reactions which sometimes occur after a traumatic event. This

questionnaire is concerned with your personal reactions to the traumatic event which

happened to you. Please indicate (Yes/No) whether or not you have experienced any of the

following at least twice in the past week.

1. Upsetting thoughts or memories about the event that have

□ No

□ Yes

come into your mind against your will

□ No

□ Yes

2. Upsetting dreams about the event

□ No

□ Yes

3. Acting or feeling as though the event were happening again

4. Feeling upset by reminders of the event

□ No

□ Yes

5. Bodily reactions (such as fast heartbeat, stomach churning,

□ No

□ Yes

sweatiness, dizziness) when reminded of the event

6. Difficulty falling or staying asleep

□ No

□ Yes

7. Irritability or outbursts of anger

□ No

□ Yes

8. Difficulty concentrating

□ No

□ Yes

9. Heightened awareness of potential dangers to yourself and

□ No

□ Yes

others

10. Being jumpy or being startled at something unexpected

□ No

□ Yes

Source: Brewin, C. R., Rose, S., Andrews, B., Green, J., Tata, P., McEvedy, C., Turner, S. & Foa, E. B. (2002) Brief

screening instrument for post-traumatic stress disorder. British Journal of Psychiatry, 181, 158-162.

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Trauma Screening Questionnaire

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