PTSD Checklist Stressor Specific Version (PCL-S)

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PTSD Checklist Stressor Specific Version (PCL-S)

The event you experienced was: ________________________________________on:___________________________

Instruction to patient: Below is a list of problems and complaints that veterans sometimes have in response to stressful life 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 last month.

No.	Response:	Not at all (1)	A little bit (2)	Moderately (3)	Quite a bit (4)	Extremely (5)
1.	Repeated, disturbing memories, thoughts, or images of the stressful experience?
2.	Repeated, disturbing dreams of the stressful experience?
3.	Suddenly acting or feeling as if the stressful experience were happening again (as if you were reliving it)?
4.	Feeling very upset when something reminded you of the stressful experience?
5.	Having physical reactions (e.g., heart pounding, trouble breathing, or sweating) when something reminded you of the stressful experience?
6.	Avoid thinking about or talking about the stressful experience or avoid having feelings related to it?
7.	Avoid activities or situations because they remind you of the stressful experience?
8.	Trouble remembering important parts of the stressful experience?
9.	Loss of interest in things that you used to enjoy?
10.	Feeling distant or cut off from other people?
11.	Feeling emotionally numb or being unable to have loving feelings for those close to you?
12.	Feeling as if your future will somehow be cut short?
13.	Trouble falling or staying asleep?
14.	Feeling irritable or having angry outbursts?
15.	Having difficulty concentrating?
16.	Being “super alert” or watchful on guard?
17.	Feeling jumpy or easily startled?

Weathers, F.W., Huska, J.A., Keane, T.M. PCL-S for DSM-IV. Boston: National Center for PTSD – Behavioral Science Division, 1991.
This is a Government document in the public domain.

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