Self-Assessment

Question 1: During the past month, have you often been bothered by feeling down, depressed, or hopeless?

• Yes No

Question 2: During the past month, have you often been bothered by having little interest or pleasure in doing things?

• Yes No

Question 3: Have you been using alcohol more than you meant to?

• Yes No

Question 4: Have you been feeling like you wanted or needed to cut down on your drinking?

• Yes No

Question 5: Have you had nightmares about combat or thought about it when you did not want to?

• Yes No

Question 6: Have you tried hard not to think about combat or went out of your way to avoid situations that remind you of Combat?

• Yes No

Question 7: Are you constantly on guard, watchful, or easily startled?

• Yes No

Question 8: Do you feel numb or detached from others, activities or your surroundings?

• Yes No

Question 9: Over the last 2 weeks, how often have you been bothered by feeling nervous, anxious or on edge?

• None at all.
• Several days.
• More than half the days.
• Nearly every day.

Question 10: Over the last 2 weeks, how often have you been bothered by not being able to stop or control worrying?

• None at all.
• Several days.
• More than half the days.
• Nearly every day.

Question 11: Over the last 4 weeks have personal concerns resulted in you not being able to carry on with your usual social, occupational or other important areas of life?

• Yes No