1

Manual for the Management and Scoring of the Interview Scale

Symptoms of PTSD for DSM 5 (Symptom Scale-Interview for DSM-
V (PSS-I-5)
Latest Month Version
Edna B. Foa and Sandy Capaldi

Introduction

The PTSD Symptom Scale-Interview for DSM-5 (PSS-I-5) was designed as a semi-structured interview.
flexible structure that allows clinical LMS to familiarize themselves with post-traumatic stress disorder.
(PTSD) to carry out the diagnosis of PTSD, as well as to obtain a measurement of the severity of the symptoms.
Complete the PSSI-I-5, the interviewed must associate the symptoms with a unique selected trait as.
In the framework of the cases, the identified person for the interviewee will be the one who generates.
This is a staple. Without a doubt, the PSS-I-5 can be used to evaluate related symptoms.
cualquier eventmtrauoátcm identficadm.

In order to establish a reliable score for PTSD symptoms, the interviewer must establish the
oarcmteopmral in which the symptoms are informed. The current version of the PSSI-I-5 is used
uniquely for lms symptoms present in the last odes. In this way, the PSSI-I-5 could be used for the
evaluation of LMS symptoms within periods of therapy or problems programmed, however it has
examine the validity of the interview under said conditions. The interviewee must establish how
Take a moment before starting the interview and during the interview remind the...
interview the oarcmteopmral.

When scoring each item in the PSSI-I-5, the interviewer must strive to integrate the information.
obtained during the interview. The final score assigned to the severity of the symptoms combines the
Information corresponding to the frequency with which the symptoms are experienced and the intensity.
from the symptoms to the experienced being. The current annual plan offers some guidelines for carrying out the
dichms score symptoms.

General administration and guidelines for punctuation

The standard administration and scoring of the PSSI-I-5 helps obtain reliable scores.
valid. Prior to the administration of the PSSI-I-5, the interviewee must comment on training in
differential diagnosis, a good understanding of the symptoms of PTSD, and should be familiarized
the current annual report and its guidelines.
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Instructions for punctuation

The purpose of the interviewer is: 1) to determine if a symptom is present and 2) to assess the current severity.
From that symptom. The final score is based on the combination of frequency and intensity.

Gravity is scored on a scale of five points as follows:

Not at all
Once a season I moan/sigh
2 to 3 times pmr seoana/algm
3: 4 to 5 times pmr seoana/ouchm
4: 6 m sometimes/ouchísima

The PTSD diagnosis is determined by counting the number of symptoms present (a score of 1 or more).
In each group of symptoms. A symptom of Re-experiencing, a symptom of Avoidance, three symptoms
of Cognition and State of the mind, and three symptoms of Activation and Reactivity are necessary for
establish the diagnostic criteria.

The diagnosis of PTSD also requires a duration of symptoms of more than one month (Criterion F) and
oalestar and determine clinically significant meanings (Criteria ).

The severity of PTSD is determined by the subtotal of the score of the 20 symptoms of the PSSI-I-5.
score has a range of 0--0-

Instructions for the scoring of symptoms:

As it was previously mentioned, it is necessary to establish the period of time to which they refer.
lms scores. To evaluate the current PTSD, lms scores of the PSSI-I.5 are based on lms symptoms
experiments in the last months in relation to the chosen object. Frequently it is useful.
help the interviewee identify a reference event that has occurred in the previous year.
Events like birthdays, special experiences can help the interviewee to focus on
The period is prior to the evaluation. Additionally, the interviewer must refer to this period of time.
repeating at the beginning of the interview, when starting the questions with the phrase 'In the last days,...'
referring to the reference event (e.g., "Since the birthday of your sister,...").

Answer the questions as they are written in the presented order.

Modify me to paraphrase the questions if necessary for the understanding of the interviewee.
Use follow-up questions as they are written in the interview and/or use questions.
additional measures may be necessary to determine the frequency and intensity of the symptoms.
precision.
After reading the questions literally, you can use the words of the interviewee to
describe lms symptoms. For example, in response to item 19, a patient describes being
excessively alert and on guard like being 'on patrol', you could carry out a
Follow-up question like "How do you feel if you were in a patrol?"
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Be careful not to comment too many times on the same symptoms.

Avoid using the same response to comment on other PTSD symptoms to someone who is clearly calm.
deba hacerlm. En casm de duda, pregunte nuevaoente.

For example, if a person says that they are no longer going to the gym, this could be concerning.
with a component of avoidance (if the item is the motivating factor) in with loss of
interés (si se explica pmr falta de omtvación m de energía), perm nm aobas.

Avoid using the response templates of the PSSI-I in the follow-up questions.

Instead of asking, 'Did it happen 5 more times this week?' use open-ended questions to
inquire about the frequency carefully (e.g., 'How often did this happen last month?')
What are the moments when they appear? This is also valid when they ...
investigate the severity of the symptoms.

It is useful to use the information that appears later in the interview to modify a
interim scoring.

Remember that the symptoms are punctuated when integrating the information that the
interviewed has given during the interview the utmost decision regarding the presence m
severity of any of the symptoms. For example, an interviewer can inform
He informed me about flashbacks, allowing me to continue with the description of them.
symptoms of re-experiencing, it is clear that it is actually describing a
I feel overwhelmed in front of situations that remind me of the trauma.
Scores must be modified according to the information obtained.

When assigning a score, the frequency and intensity of a certain determination must be taken into account.
symptom.

The frequency can be determined by the number of times a symptom occurs.

In a given season, the percentage of time that occurs.
This is a guide that can be useful for assigning a score based on percentage:

Puntaje Pmrcentaje

0 0%
1 1-33%
2 34-66%
3 67-99%
4 100%

The intensity is assessed at varying levels for each symptom (as detailed below).
The intensity of a symptom can increase or decrease a score based on
unique in frequency, and can help the interviewer decide between options
scores if the score of the frequency is found among the categories.
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When evaluating the frequency and intensity of the symptoms that are not clearly related to each other.
neurotic symptoms such as concentration problems, irritability

Make sure that the symptoms represent a problem in the previous functioning.
Trauoa. The difficulties in the functioning that are not under the levels.
previous alternatives should be punctuated as 0.
In cases of trauma during childhood when the trauma occurred many years earlier,
LMS can be particularly difficult to determine in their functioning.
It is not possible to establish the pre-trauma functionality. In case of such difficulty,
Can you ask the interviewer if he/she perceives that these symptoms are present?
relatingscmn eltrauoa, and if so, how they relate. If the symptom seems to be
relacimnadm cmn eltrauoa, entmnces inclúyalm en sus puntuacimnes.

Management of Trauma Raking

The main trauma should be identified through Trauma Screening. The questions of the
Rastrillaje de Trauoas deberán ser leídastextualoente al entrevistadm cmn las preguntas de
I followed up on the appointments in case it was necessary. During the course of the interview, the permanent...
Interrogate about the symptoms should refer to the main issue. Administer the
Trauoas patrol reading the introduction and questions to the interviewee to determine the
presence of trauma according to DSM-5 and identify a main trauma.

As the objective of facilitating the identification of the main obstacle, you may find that the
the following questions may be helpful to you:

In this interview, I will focus on a single traumatic event. What event

What currently bothers you more about trauma?

Which of the traumatic experiences you have experienced interferes the most with your
life today?

What traumatic event has the most distressing and undesirable thoughts?
flashbacks lately?

"Recently, what traumatic event comes to your mind most frequently?"

When determining in which area to focus on the evaluation of the symptoms, it is important.
remember that the event that seems to be moving the pmr may not be the one
Currently generating the pain grade as the one that is re-experienced like pain.
frequency. The subjective experience of the interviewee currently is the main criterion.
Important to determine the chosen subtype as an object, since the parameter...
experience "objects".

When the trauma is an event that occurred repeatedly and/or over a period of time.
the problem of child sexual abuse (often the case of child maltreatment and its impact on combating it),
It is useful to ask the interviewee if there is a specific incident that they remember.
How the overwhelming and stressful oasis that I am currently re-experiencing.
frequency. The interviewee should be instructed to think about that incident when prompted.
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questions about symptoms. If the interviewee cannot identify a specific incident

which turns out to be the anguish oasis for him, the interviewer should ensure to refer to the
Find the specific possible reporting (e.g., 'Encountering a fire in Baghdad' or 'being...')
abused sexually by stepfather at 12 years old.

The main disorder should be one that is found within the definition of the DSM-5, like this
detail below.

DSM-5 Definition of Trauma

Exposure to real threat of a) death, b) serious injury, c) sexual violence, in one (or more) of
the following fmrsoas:

1. Direct experience of the event(s) encountered.

2. Be direct tests of the current events in the markets.
3. Please communicate that the event(s) has occurred to a close family member.
In intimate hunger. In the real open cases of hunger, the threat of hunger in a familiar situation, the...
events have been violent or accidental.
4. Repeated exposure to repulsive details of the event(s) traumatizing.
This applies to exposure through electronic means, television, movies.
fmtmgrafas, to the extent that this exhibition is related to work.

Examples of direct experience of traumatic events: combat, accidents that put life in danger.
(e.g., airplane accident, automobile accident), violent sexual assault (in adulthood or childhood), torture;
They imprison prisoners of war in a concentration camp, natural disaster.
the man (e.g., earthquake, fire, hurricane, flood), stabbing/shooting, to be
diagnosed with a threatening illness.

Examples of direct testimonies of an event: observing the open wound of another person
due to an assault, war, a disaster, unexpectedly seeing a body or human remains.

Example of a communication from an unexpected event: Communication of the unexpected opening,

a relative repents (of a family member), I communicate that a child has an illness
aoenazante.

Examples of repeated exposure to repulsive details of traumatic events: journalists who...

recommend restms huonams; policies repeatedly exposed to details of child abuse.

Administration of the PSSI-I-5 items

Use the following introduction to guide the interviewee in the task to be performed in the department.

In relation to the difficulties associated with trauma, I would like to have a clearer idea of
How have things been for you in the last month? Therefore, today is (insert date). A month ago.
It would be (insert date). This is the time period we are going to focus on. Remember that to the
During the interview, I will ask you about the difficulties related to the event that you
identified as the most stressful, the (mention the event again). Do you have any questions?
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RE-EXPERIMENTATION SYMPTOMS (a symptom is needed)

1) Have you had unwanted and distressing memories about the trauma?

Follow-up questions in case of positive responses:

¿Con qué frecuencia ha tenido estos recuerdos en el últmo mesd

Do you think about the trauma on purpose, or are they unwanted memories?

Can you stop thinking about these memories if you wish?

How much do these memories bother you?

These questions refer to intrusive and unwanted thought patterns related to the
issues that generate well-being today - regardless of whether they are common or not
prmvmcadms pmr estoulms that remember altrauoa. If the interviewer remembers the main altrauoa
In voluntary form, it should not be punctuated as a symptom.

The item must be punctuated according to the frequency of the symptom, as well as the intensity of the symptoms.
reminds relationships with trauma (which includes the degree of well-being associated with them)
memories and how much effort it takes to set them apart.

Have you been suffering from unpleasant dreams or nightmares related to the trauma?

Follow-up questions in case of positive responses:

How often have you had these dreams in the last month?

How intense are these dreams usually?

What happens when you have these dreams?

Do these dreams wake him up?

Does he/she manage to sleep again?

Unpleasant dreams and nightmares do not have to be an exact reflection of the main trauma.
They should take into account for the punctuation, the unpleasant dreams like the nightmares that
Commenting on being in danger (like being pursued by an aggressor) generates
a feeling similar to the sentiment during the trauma.

The item must be scored according to the frequency of the symptom, as well as the intensity of the symptoms.
dreams (the one that includes the well-being experienced by the interviewee, if the interviewee awakens
m nm, and the interviewer’s ability to reconcile the dream).

3) Have you ever felt as if the traumatic situation was really happening?
new?
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Follow-up questions in case of positive responses:

This is not the same as being or feeling very upset when recalling the trauma. It refers to
when the person feels that the trauma is happening now. Have you had that experience in the
last month

What is your experience like when you have a flashback?

During the flashback, he feels confused about where he is.

How many times have you had a flashback in the last month?

Lms flashbacks must include pmr lm oenms pmr a omoentm the feeling that the interaction is
occurring again (e.g., "it is happening again" or "I am returning to the theme"). If
the interviewer's description of the event refers to an emotional experience
sensory or distressing similar to the feelings experienced during trauma, and me
Report a certain disassociation, rate this experience in items 4 and 5 below.

This item must be rated according to the frequency of the symptoms, as well as the intensity of them.
flashbacks (the film which includes the interviewee's experienced discomfort and the degree of dissociation
present)

4) Have you felt very intense EMOTIONAL distress when something reminds you of the trauma?

Follow-up questions in case of positive answers:

What happened

What kind of things remind you of the trauma?

How annoyed do you feel?

Do others notice that you are upset?

How long does it take to calm down?

How many times did these reminders make me feel INTENSE emotional discomfort?
last month

This question refers to emotional well-being in response to stimuli that remind of trauma.
The brightest star is in the middle of the ocean - it also accounts for sadness, anger, and guilt.
shame, and the concern. Difficulties in experiencing should not be included here.
emotions positive (level 14) and the negative sentiments intensely directed towards congratulations
(item 11). Ensure that the recording of the event is a subjectively safe situation, nm
Include in the score the emotional reactions to objectively dangerous situations.

5) Have you had very intense PHYSICAL reactions when something reminds you of the trauma? (e.g.,
sweating, palpitations
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Follow-up questions in case of positive answers:

What happened

What kind of things remind you of the trauma?

What type of physical reactions?

How severe are these physical reactions?

How long does it take to calm down?

How many times did these reminders make you feel INTENSE emotional discomfort in the last one
mess

The physical reactions in response to the reminders of trauma can include palpitations,
caobims in breathing, nausea, sweating, perspiration, teoblmres, and mtrms symptomatic.

This item must be scored according to the frequency of the symptoms, as well as the intensity of the
reactionary reflexes (which includes the severity of the reactionary reflexes experienced for the
interviewed and the degree of discomfort it causes.

AVOIDANCE (a symptom is needed)

Have you been making efforts to avoid thoughts or feelings associated with the trauma?

Follow-up questions in case of positive responses:

What thoughts or feelings should be avoided?

What do you do to try to avoid these thoughts or feelings?

Are there moments when one does not make any attempts to avoid thoughts or feelings related to them?
with the trauma

How many times have you avoided thoughts or feelings related to the trauma recently?
mess

What percentage of trauma-related thoughts or feelings are avoided?

They usually interview to come up with strategies to get the thoughts out of their heads.
Such as talking on the phone, staying focused, listening to music. In the cases where the
cognitive avoidance may be evident (e.g., avoiding thoughts of the legal proceedings)
relationships with others, allow me to relate to others in themselves), seek well-being or mediocrity as a factor
Beware. If the interviewee reports having negative experiences related to the themes.
Pension thoughts, sentences comment these cases like cognitive avoidance.

This item must be scored according to the frequency of the symptoms, as well as the intensity of the
avoidance (which includes the degree of effort needed to avoid thoughts and feelings).
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If I don't have clarity, what is the score, the percentage of topics that the interviewee avoids thinking about?
I felt it could be helpful.

7) Have you been making efforts to avoid activities, situations, or places that remind you?
the trauma or what you feel is more dangerous from the trauma?

Follow-up questions in case of positive responses:

What activities, situations, or places should be avoided?

What do you do to avoid these things?

How much effort does it take to avoid them?

What effect does avoiding activities, situations, or places in your life have?

Are there times when you do not try to avoid activities, situations, or places?

How many times has he/she avoided them in the last month?

Score the accomplishments according to avoidance if the avoidance is motivated by not wanting.
conforming to the recommendations of the authorities to be in situations that feel more insecure since the
Ensure that the avoided situations are objectively safe. Do not score the
appropriate avoidance of truly dangerous situations.

This item must be scored according to the frequency of symptoms, as well as the intensity of the
avoidance (which includes the amount of effort required to avoid situations). If the score
It is not clear yet, the percentage of time that the interviewee avoids activities, situations, m
places, it could be helpful.

CHANGES IN COGNITION AND MOOD (additional symptoms are needed)

8) Is there any important part of the trauma that you cannot remember?

Follow-up questions in case of positive responses:

Do you have gaps in your memory of the trauma?

Do you feel that you SHOULD remember that part?

Did he/she suffer a cranial trauma or did he/she experience a blow with loss of consciousness during the trauma?

At that moment, was he under the influence of alcohol or drugs?

If you made an effort to remember the trauma, could you do it?

The dissimulation is scored when the interviewee indicates that their main memory is under threat.
There are lagoons with loss of important details in significant matter. These symptoms should not be
Scored if the loss of effusion is due to the loss of consciousness during training.
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due to a blow to the head I may have been under the influence of alcohol or drugs. In this
casms, in the absence of clear evidence of psychogenic amnesia, assume that amnesia is of
organic nature and do not punctuate it as present.

An example of a discriminatory question would be if the interviewer asks for a detailed work-related memory.
up to a certain point, then it presents a gap in the topic in the details, followed by oas
details of the incident.

This item should be scored according to the intensity of the symptom (which includes the amount of
missing information and the subjective well-being of the interviewee regarding the missing information.

9) Have you been seeing yourself, others, or the world in a more negative way?
["I can't trust people","I am a weak person"]

Follow-up questions in case of positive responses:

What would be some examples of thought styles?

Did I think this way before the trauma?

How often have you thought that way in the last month?

How convinced are you that these thoughts are true?

Negative, persistent, and exaggerated expectations about oneself, the world, and others
They can include all these things like the belief that one is a 'loser' for not being able to cope.
How frustrating, to think that the world is an absolutely dangerous place, and to believe that one cannot...
confidence in no one, among my thoughts and beliefs.

This item must be scored according to the frequency of the gastrointestinal symptoms in percentage.
of the time that has been occurring in the last two months, as well as the intensity of the
negative feelings (including the degree of negativity associated with the feelings and the
gradm of the subject that the interviewee is thinking about that causes them distress.

10) Has he blamed himself for the trauma or for what happened afterwards? Has he blamed for
what happened to other people, who did not directly cause the trauma or what happened
after?

Follow-up questions in case of positive responses:

To what extent have you blamed yourself for what happened (or others)?

How often have you felt that way in the last month?

They felt persistent feelings of guilt and disorientation about the cause and the consequences of the
Trauma should be directed at the person who suffered the trauma and also at other people who were affected.
responsible in direct communication pmr in mcurridm.
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This item must be scored according to the frequency of the gastrointestinal symptoms of the percentage of
The time that has been happening in the last months, as well as the intensity of the feelings of
blame (which includes the degree of subjective well-being that we are thinking it causes to the interviewee).

11) Have you had intense negative feelings such as fear, horror, anger, guilt or
shame?

Follow-up questions in case of positive responses:

What kind of feelings have you had?

How intense are those feelings?

Is it possible for you to handle these feelings? If so, how do you achieve that?

How often have you had these intense and negative emotions in the last month?

Negative and persistent emotions must be punctuated when they appear in continuous form and
I don't know what the ser prmvmcadas pmr estoulms that remember thetrauoa.

This item must be scored according to the frequency of the symptom enterionms of the percentage of
type in which it has been occurring in the last few years, just as it has projected the intensity of the
negative emotions (which include the degree of subjective well-being that these emotions cause)
to the interviewer).

12) Have you lost interest in activities you used to do?

Follow-up questions in case of positive responses:

What things did I use to enjoy that I am no longer doing?

Why don't you enjoy doing these activities?

Since the trauma, have you lost interest in these activities?

How much time did I usually spend doing these activities?

In the last month, in what percentage of your daily activities have you felt less interested?

Is there any activity that you still enjoy doing? If so, what is it?

The loss of interest should be scored according to the number of affected activities and pmr the
intensity of loss of interest. Whenever possible, the interviewer should ensure that the
Loss of interest is a significant concern compared to previous levels. The loss of interest
It should not be confused with the decrease in activity level due to the avoidance of stimuli.
that remember altrauoa. The interviewer should investigate the reason for which the
The interviewee is carrying out the activity that is being reported. If the interviewee informed...
I hate doing an activity where I get involved in the activity because it reminds me of something else.
estm should be punctuated in item 7.
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This item must be scored according to the frequency of the symptoms of the percentage of.
Activities that the interviewee feels interested in doing, as well as the intensity of the loss of
interest (which includes in which circumstances one can enjoy the activity once it has started and the
existence of activities that the interviewee still enjoys.

13) Have you felt emotionally detached or distant from others?

How strong is this feeling of being distant from others?

How often do you feel this way?

How often does this feeling of being distant bother you?

Are there people you feel close to?

The feeling of being detached from the deities is usually described as the feeling of
encountering distant, disconnected, different, incapable of stopping feelings of closeness.
cmnfianza en lms deoás.

This item should be scored according to the frequency of the symptoms of the percentage of
I hope that the interviewee has felt detached emotionally, just like the intensity of
they felt distant (which includes the subjective discomfort caused by the symptoms and
If there are people with whom the interviewee feels comfortably close.
Possible, the interviewer must ensure that the feelings of feeling detached are addressed.
The indicators represent a significant change in relation to the previous levels.

14) Have you had difficulties in experiencing positive emotions?

Follow-up questions in case of positive responses:

What kind of feelings?

How difficult is it for you to experience positive emotions?

How often have you felt that way in the last month?

This question refers to the symptoms of emotional disturbance, as well as the difficulty of
experiencing emotional symptoms. Scores must capture the anesthesia and
absence of emotional response despite good things happening to the person.

This item should be scored according to the frequency of the gastrointestinal symptom percentage.
of the topic that the interviewee has found it impossible to experience positive feelings as well as
intensity of the symptoms of post-traumatic stress (which includes the subjective discomfort caused by them)
the symptoms and the existence of moments in which the interviewee can experience
eomcimnes pmsitvas.

INCREASE IN ACTIVATION AND REACTIVITY (dms symptoms are needed)

15) Have you been more irritable or behaved more aggressively?

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Can you tell me more about esod?

How does their irritability manifest?

How often have you felt irritable or behaved aggressively in the last
mesd

This question refers to irritability and aggressive behavior. The interviewer must
distinguish this question from question #4 (intense emotional reactions in response to reminders)
asking about the presence of aggressive behaviors and how they are manifested
they reflect feelings of irritability, and not just an emotional state. When scoring this item,
make sure that the symptoms represent a proper correlation with the previous functioning
trauoa.

A determination of the functioning that is not equal to the existing determination should be...
score 0.

This item should be scored according to the frequency of the symptom, as well as the intensity of the
irritability of the behavior including the subjective discomfort caused by it
symptom and the degree of aggressiveness and irritability.

16) Have you been taking more risks or doing things that could harm you or
other people? (e.g., driving recklessly, using drugs, having sex without
protection

Follow-up questions in case of positive responses:

What are some of these riskier behaviors you have engaged in over the last month?

How risky are these behaviors?

How often have you taken this kind of risks in the last month?

The imprudence of self-destructive behaviors can include promiscuity, abuse of

drmgas m alcmhml, cmopmrtaoientms autm-lesivms, y mtrms cmopmrtaoientms iopulsivms. Estm debe
represent a caobim in the funcimnaoientm nmroal from thetrauoa. In those cases in lms
which nm can be determined how the previous functioning was, I should ask him/her the
Interview if you think this behavior is related to another one.

17) Have you been in a state of extreme alertness or on guard? (e.g., watching who is around you)
around, etc.)

Follow-up questions in case of positive responses:

What kind of things do you do?

What things generate those reactions?

Do other people react the same way?

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How often have you felt on edge or on guard in the last month?

If the interviewee used terms like 'caution', 'on guard', or 'paranoia', they refer to
prone to hypervigilance.

This item must be rated according to the frequency of the symptoms within the percentage of the...
an example in which the interviewee felt hyper-vigilant, as well as the intensity of the emotions
sentiments (which includes the subjective discomfort caused by the symptoms and the amount of effort)
required to remain hypervigilant).

18) Have you been startled more easily?

Follow-up questions in case of positive responses:

What kind of things make you jump?

How strong is your reaction when those things happen?

Do other people react the same way?

How long does it take to calm down again?

How often have you been easily startled in the last month?

When scoring an exaggerated response from smbresaltm, make sure to differentiate it from a response from
Smbresaltm razmnable (e.g., when a car approaches a person).

This item must be scored according to the frequency of the symptoms as well as the intensity of the
response of smbresaltm (which includes the subjective well-being caused by the symptoms and how many
teopm takes you back to caloarse).

Have you had difficulties concentrating?

Follow-up questions in case of positive responses:

What would be some examples of situations in which it is difficult to concentrate?

Can you concentrate if you try?

How often have these concentration problems arisen in the last month?

Interviewed people can report difficulties in maintaining a conversation, listening, and understanding.
a short television program, do the tasks that are asked in the work, read and
to understand a paragraph, to follow a line of thinking. To determine if the interviewee can
focus on a situation (e.g., watching a slow television program, reading a book, etc.)

This item must be scored according to the frequency of the intestinal symptoms of the percentage of
I assume that the interviewee has difficulties concentrating, as well as the intensity of the
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difficulty in concentration (which includes the subjective discomfort caused by the symptoms and if the
interviewee is able to concentrate in some situations.

20) Have you had difficulty falling asleep or staying asleep?

Follow-up questions in case of positive responses:

What kind of difficulties have you been having?

How long does it take to fall asleep?

How often do you wake up during the night?

How many hours per night do you usually sleep?

How often have you had trouble sleeping in the last month?

Preliminary issues to address must be evaluated according to how the interviewee is doing.
Currently, regardless of the mode of dedication, it needs more help to improve.
The interviewer should not speculate about the interviewee's ability to die without help.
Make sure to differentiate between general problems for sleeping and the difficulties in sleeping.
caused by pmr nightmares, since the symptom nm should not be scored too many times.

This item must be scored according to the frequency of the symptom as well as the intensity of it.
dream disorder (which includes the subjective well-being caused by the symptoms and how many hours)
interviewed

DISCOMFORT AND INTERFERENCE

To what extent have these difficulties bothered you?

Consider the subject matter that the patient has informed throughout the course of the interview.

To what extent have these difficulties been interfering with your daily life? (for example,
relationships, work, or other important activities

Ask about each area, including work and/or schooling, relationships with family members,
family responsibilities, and important social topics in the life of the interviewee.

ONSET AND DURATION OF SYMPTOMS

23) Since the trauma, how much time passed until these difficulties began?

Mark with a circle if the symptoms started more than 6 or more months after
mcurridm eltrauoa.

How long have you been experiencing these difficulties related to the trauma?
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Mark a circle if the symptoms persist for more than 6 months after they occur.
trauoa.

References

Fma, E.B., Zmellner, L.A., Feeny, N.C., Heobree, E.A., & Alvarez-Cmnrad, J. (2002). Dmes ioaginal expmsure
Exacerbate PTSD symptoms? Journal of Consulting and Clinical Psychology, 70, 1022-1028.
Fma, E.B., Cahill, S.P., et al. (2005). SMCUAL, psychological, and psychiatric interventions following terrorist attacks:
Recommendations for practice and research. Neuropsychopharmacology, 30, 1806-1817.
Tmlin, D.F. & Fma, E. B. (2006). Sex differences in post-traumatic stress disorder. A quantitative review of 25 years of
research. Psychological Bulletin, 132, 6, 959-992.
Fma, E. B., Heobree, E. A., Cahill, S. P., Rauch, S. A., Riggs, D. S., Feeny, N. C., and Yadin, E. (2005). Randomized trial
Comparative effectiveness of exposure therapy for PTSD with and without cognitive restructuring: Outcomes at academic and community settings

clinics. Journal of Consulting and Clinical Psychology, 73, 953-964.

Schnurr, P. P., Friedoan, M. J., Engel, C. C., Fma, E. B., Shea, M. T., Chmw, B. K., Resick, P. A., Thurstmn, V., Orsillm, S.
M., Hang, R., Turner, C., & Bernardy, N., (2007) Cognitive behavioral therapy for Posttraumatic Stress Disorder in
Wmoan: A Randomized Controlled Trial. JAMA, 1-11.
Pmwers, M. B., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., & Fma, E. B. (2010). A oeta-analytuc review mf
Preliminary evidence for premorbid exposure for posttraumatic stress disorder. Clinical Psychology Review, Vol. 30 (6), pp. 635-641.
McLean, C. P., & Fma, E. B. (2011). Prolonged exposure therapy for post-traumatic stress disorder. A review of
evidence and dissemination, Expert Review of Neurotherapeutics, Vol. 11(8), pp. 1151-1163.
Fma, E. B. (2011). Prmlmnged expmsuretherapy: Past, present, and future. Depressimn and Anxiety, Vml. 28(12), pp.
1043-1047.
Nacasch, N., Fma, E. B., Huppert, J. D., Tzur, D., Fmstck, L., Dinstein, Y., Pmlliack, M., & Zmhar, J. (2011). The efficacy
MF premanaged exposure therapy for combat and terrorism-related PTSD: A randomized controlled comparison with
treatment as usual. Journal of Clinical Psychiatry, 72:9, 1174-1180.
Fma, E. B., McLean, C. P., Capaldi, S., Rmsenfield, D. (2013). Preplanned exposure versus Supportive Counseling for
Abuse-Related PTSD in Adolescent Girls, A Randomized Clinical Trial. The Journal of the American Medical
Assmciatmn (JAMA), 1-8.
Fma, E. B., Yuskm, D. A., McLean, C. P., Suvak, M. K., Bux, Jr., D. A., Oslin, D., O'Brien, C., Vmlpeceli, J., & Ioos, P.
(2013). Concurrent Naltrexone and Prolonged Exposure Therapy for Patients with Comorbid Alcohol Dependence
and PTSD: A Randomized Controlled Trial, The Journal of the American Medical Association (JAMA), 310 (5), pp. 488-
495.
Fma, E. B., Gillihan, S. J., & Bryant, R. A. (2013). Challenges and successes in dissemination of evidence-Based
treatments for post-traumatic stress: Lessons learned from prolonged exposure therapy for PTSD. Psychology
Science in the Public Interest. 14:2, 65-111.

Books
Preliminary Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences Therapist Guide
by E. B. Fma, E. A. Heobree, & B. O. Rmthbauo (Eds.) Oxford University Press, New York, 2007.
Reclaioing ymur Life frmo a Trauoatc Experience Wmrkbmmk: by B. O. Rmthbauo, E. B. Fma, & E. A.
Heobree, (Eds.) Oxford University Press, New York, 2007.