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Brief Trauma Questionnaire
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Brief Trauma Questionnaire
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1. Have you served in a war zone or in a noncombat job that exposed you to war related casualties?
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1a. If yes, were you serious injured or did you think your life was in danger or that you might be seriously injured?
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2. Have you been in a serious accident?
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2a. If yes, were you serious injured or did you think your life was in danger or that you might be seriously injured?
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3. Have you been in a major natural or technological disaster like a fire, tornado, hurricane, flood, or chemical spill?
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3a. If yes, were you serious injured or did you think your life was in danger or that you might be seriously injured?
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4. Have you had a life threatening illness such as cancer, a heart attack, leukemia, AIDS, or multiple sclerosis?
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4a. If yes, did you think your life was in danger?
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5. Before the age of 18, were you physically punished or beaten by a caretaker?
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5a. If yes, were you frightened, thought you would be injured, or had marks or actually had injuries?
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6.Not including question 5's response, were you ever attacked, beaten, or mugged by anyone (incl friends, family, strangers)?
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6a. If yes, were you serious injured or did you think your life was in danger or that you might be seriously injured?
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7. Has anyone made or pressured you into have unwanted sexual contact?
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7a. If yes, were you serious injured or did you think your life was in danger or that you might be seriously injured?
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8.Have you been in another situation where you were seriously injured or thought that you might be seriously injured or killed?
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9. Has a close family member or friend died violently (car crash, mugging, attack)?
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10. Have you witnessed a situation where someone was seriously injured or killed or feared they might be?
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Comments
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