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About The SGB
PTSD Questionnaire
SGB for PTSD
Locations
- SGB Injection Treatment Barcelona
Blog
Contact Us

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Complete the PTSD & Anxiety Questionnaire

Below is a list of problems and complaints that people with PTSD sometimes have in response to stressful life experiences.

Please read each one carefully, then circle one of the numbers to the right to indicate how much you have been bothered by that problem in the past month.

Select your preferred location

How did you hear about us?

1) Repeated, disturbing memories, thoughts, or images of a stressful experience from the past?

Not at all A little bit Moderately Quite a bit Extremely

2) Repeated, disturbing dreams of a stressful experience from the past?

Not at all A little bit Moderately Quite a bit Extremely

3) Suddenly acting or feeling as if a stressful experience were happening again (as if you were reliving it)?

Not at all A little bit Moderately Quite a bit Extremely

4) Feeling very upset when something reminded you of a stressful experience from the past?

Not at all A little bit Moderately Quite a bit Extremely

5) Having physical reactions (e.g., heart pounding, trouble breathing, sweating) when something reminded you of a stressful experience from the past?

Not at all A little bit Moderately Quite a bit Extremely

6) Avoiding thinking about or talking about a stressful experience from the past or avoiding having feelings related to it?

Not at all A little bit Moderately Quite a bit Extremely

7) Avoiding activities or situations because they reminded you of a stressful experience from the past?

Not at all A little bit Moderately Quite a bit Extremely

8) Trouble remembering important parts of a stressful experience from the past?

Not at all A little bit Moderately Quite a bit Extremely

9) Loss of interest in activities that you used to enjoy?

Not at all A little bit Moderately Quite a bit Extremely

10) Feeling distant or cut off from other people?

Not at all A little bit Moderately Quite a bit Extremely

11) Feeling emotionally numb or being unable to have loving feelings for those close to you?

Not at all A little bit Moderately Quite a bit Extremely

12) Feeling as if your future will somehow be cut short?

Not at all A little bit Moderately Quite a bit Extremely

13) Trouble falling or staying asleep?

Not at all A little bit Moderately Quite a bit Extremely

14) Feeling irritable or having angry outbursts?

Not at all A little bit Moderately Quite a bit Extremely

15) Having difficulty concentrating?

Not at all A little bit Moderately Quite a bit Extremely

16) Being "super-alert" or watchful or on guard?

Not at all A little bit Moderately Quite a bit Extremely

17) Feeling jumpy or easily startled?

Not at all A little bit Moderately Quite a bit Extremely

18) Feeling Nervous, anxious or on edge

Not at all Several days More than half the days Nearly every day

19) Not being able to stop or control worrying

Not at all Several days More than half the days Nearly every day

20) Worrying too much about different things

Not at all Several days More than half the days Nearly every day

21) Trouble relaxing

Not at all Several days More than half the days Nearly every day

22) Being so restless that it is hard to sit still

Not at all Several days More than half the days Nearly every day

23) Becoming easily annoyed or irritable

Not at all Several days More than half the days Nearly every day

24) Feeling afraid, as if something awful might happen

Not at all Several days More than half the days Nearly every day

25) If you checked any problems, how difficult have they made it for you to do your work, take care of things at home, or get along with other people?

Not difficult at all Somewhat difficult Very difficult Extremely difficult

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