Primary Care PTSD Screen (PC-PTSD)

(For professional use and interpretation only.)

INSTRUCTIONS: Please respond to the following brief questions, which will help us better to evaluate your health status. Circle YES or NO for each of the following four questions.

In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past month, you...

1. Have had nightmares about it or thought about it when you did not want to? - [ ] YES / [ ] NO

2. Tried hard not to think about it or went out of your way to avoid situations that reminded you of it? - [ ] YES / [ ] NO

3. Were constantly on guard, watchful, or easily startled? - [ ] YES / [ ] NO

4. Felt numb or detached from others, activities, or your surroundings? - [ ] YES / [ ] NO

For professional use and interpretation only. From "Screening for PTSD in a Primary Care Setting", downloaded 2005.10.04 from http://www.ncptsd.va.gov/facts/disasters/fs_screen_disaster.html. This screening tool is in the public domain and may be freely duplicated. I have added text above the line "In your life...", and clarified one punctuation ambiguity in that line. For usage instructions, please see my Psychological trauma disorders - meeting the challenge in primary care settings.

Tom Cloyd, MS, MA - Counselor / Psychotherapist - Cedar City and St. George, Utah , Utah (435) 272-3332 - email: tc (AT) tomcloyd (DOT) com (please read about content licensing)

Downloadable version for user-formatting

• Primary Care PTSD Screen (PC-PTSD) (*.txt format) - This is a text-only version of the same file, which should be readable by any operating system (Mac, Linux, etc.) As it is text-only, there is no formatting preserved in the file. It will probably display "as is" in your browser. From there, select-and-copy the text to your word processor for formatting.