Name
INSTRUCTIONS TO PATIENT: Below is a list of problems and complaints that veterans sometimes have in response to stressful military experiences. Please read each one carefully, put an X in the box to indicate how much you have been bothered by that problem in the past month.
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Not at all |
A little bit |
Moder-ately |
Quite a bit |
Extre-mely |
|
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1. |
Repeated, disturbing memories, thoughts, or images of a stressful military experience? |
1 |
2 |
3 |
4 |
5 |
|
2. |
Repeated, disturbing dreams of a stressful military experience? |
1 |
2 |
3 |
4 |
5 |
|
3. |
Suddenly acting or feeling as if a stressful military experience were happening again (as if you were reliving it)? |
1 |
2 |
3 |
4 |
5 |
|
4. |
Feeling very upset when something reminded you of a stressful military experience? |
1 |
2 |
3 |
4 |
5 |
|
5. |
Having physical reactions (e.g., heart pounding, trouble breathing, sweating) when something reminded you of a stressful military experience? |
1 |
2 |
3 |
4 |
5 |
|
6. |
Avoiding thinking about or talking about a stressful military experience or avoiding having feelings related to it? |
1 |
2 |
3 |
4 |
5 |
|
7. |
Avoiding activities or situations because they reminded you of a stressful military experience? |
1 |
2 |
3 |
4 |
5 |
|
Not at all |
A little bit |
Moder-ately |
Quite a bit |
Extre-mely |
||
|
8. |
Trouble remembering important parts of a stressful military experience? |
1 |
2 |
3 |
4 |
5 |
|
9. |
Loss of interest in activities that you used to enjoy? |
1 |
2 |
3 |
4 |
5 |
|
10. |
Feeling distant or cut off from other people? |
1 |
2 |
3 |
4 |
5 |
|
11. |
Feeling emotionally numb or being unable to have loving feelings for those close to you? |
1 |
2 |
3 |
4 |
5 |
|
12. |
Feeling as if your future will somehow be cut short? |
1 |
2 |
3 |
4 |
5 |
|
13. |
Trouble falling or staying asleep? |
1 |
2 |
3 |
4 |
5 |
|
14. |
Feeling irritable or having angry outbursts? |
1 |
2 |
3 |
4 |
5 |
|
15. |
Having difficulty concentrating? |
1 |
2 |
3 |
4 |
5 |
|
16. |
Being "super-alert" or watchful or on guard? |
1 |
2 |
3 |
4 |
5 |
|
17. |
Feeling jumpy or easily startled? |
1 |
2 |
3 |
4 |
5 |
PCL-M for DSM-IV (11/1/94)
END OF TESTWeathers, Litz, Huska, & Keane; National Center for PTSD - Behavioral Science Division. This is a government document in the public domain.
Here are a few of the references on the PCL. These were taken from PILOTS database (the world's largest database on traumatic stress)
http://www.ncptsd.org/PILOTS.html. There are other citations of the PCL, which has been used in hundreds of studies. Please consult PILOTS for more information.Smith, Meredith Y; Redd, William H; DuHamel, Katherine; Vickberg, Suzanne Johnson; Ricketts, Patricia. (1999). Validation of the PTSD Checklist-Civilian version in survivors of bone marrow transplantation.Journal of Traumatic Stress (ISSN: 0894-9867), v. 12, no. 3, pp. 485-499
Campbell, Keith A; Rohlman, Diane S; Storzbach, Daniel; Binder, Laurence M; Anger, W Kent; Kovera, Craig A; Davis, Kelly L; Grossmann, Sandra J. (1999). Test-retest reliability of psychological and neurobehavioral tests self-administered by computer.Assessment (ISSN: 1073-1911), v. 6, no. 1, pp. 21-32.
Manne, Sharon L; Du Hamel, Katherine; Gallelli, Kim; Sorgen, Karen; Redd, William H. (1998). Posttraumatic stress disorder among mothers of pediatric cancer survivors: diagnosis, comorbidity, and utility of the PTSD Checklist as a screening instrument. Journal of Pediatric Psychology (ISSN: 0146-8693), v. 23, no. 6, pp. 357-366.
Andrykowski, Michael A; Cordova, Matthew J; Studts, Jamie L; Miller, Thomas W. (1998). Posttraumatic stress disorder after treatment for breast cancer: prevalence of diagnosis and use of the PTSD Checklist - Civilian Version (PCL-C) as a screening instrument. Journal of Consulting and Clinical Psychology (ISSN: 0022-006X), v. 66, no. 3, pp. 586-590.
Blanchard, Edward B; Jones-Alexander, Jacqueline; Buckley, Todd C; Forneris, Catherine A. (1996). Psychometric properties of the PTSD Checklist (PCL). Behaviour Research and Therapy (ISSN: 0005-7967), v. 34, no. 8, pp. 669-673.
Koivisto, Hanna; Haapasalo, Jaana. (1996). Childhood maltreatment and adulthood psychopathology in light of file-based assessments among mental state examinees. Studies on Crime and Crime Prevention (ISSN: 1102-3937), v. 5, no. 1, pp. 91-104.
Cordova, Matthew J; Andrykowski, Michael A; Kenady, Daniel E; McGrath, Patrick C; Sloan, David A; Redd, William H. (1995). Frequency and correlates of posttraumatic-stress-disorder-like symptoms after treatment for breast cancer. Journal of Consulting and Clinical Psychology (ISSN: 0022-006X), v. 63, no. 6, pp. 981-986.