Patient: Age: Weight:

Trauma PC-PTSD


Measure Mood

PC-PTSD: Questionnaire for Post-Traumatic Stress Disorder

Completed by:
Patient or Clinician

Purpose:
To screen for post-traumatic stress disorder

Questionnaire:
In your life, have you ever had any experience that was so frightening, horrible, or upsetting, that in the past month you:
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1.Have had nightmares or thought about it when you didn't want to?
2.Tried hard not to think about it or went out of your way to avoid situations that reminded you of it?
3.Were constantly on guard, watchful, or easily startled?
4.Felt numb or detached from others, activities, or your surroundings?

0/4 = Negative Screen
3/4 yes = positive screen

Scoring:
Add up all the "yes" answers

How to Interpret Score:
If the patient scores 3/4 or higher, this reflects a positive screen

Reference: Prins, A., Ouimette, P., Kimerling, R., Camerond, R.P., Hugelshofer, D.S., Shaw-Hegwer, J., Thrailkill A., Gusman, F.D., Sheikh, J.I. (2004). The primary care PTSD screen (PC-PTSD): development and operating characteristics. International Journal of Psychiatry in Clinical Practice, 9(1),9-14

Link to Abstract: http://www.ingentaconnect.com/content/apl/pcp/2004/00000009/00000001/art00002


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