| ENTRY SPECIFICATION |
{"name": "PCL-5",
past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>"
places, conversations, activities, objects, or situations)?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6848", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "8. Trouble remembering important parts of the stressful experience?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
{"id": "q6841", "type": "ChoiceQuestion", "required": false, "inline": true,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6849", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "9. Having strong negative beliefs about yourself, other people, or the world (for
example, having thoughts such as: I am bad, there is something seriously wrong
"text": "1. Repeated, disturbing, and unwanted memories of the stressful experience?",
with me, no one can be trusted, the world is completely dangerous)? ",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6850", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "10. Blaming yourself or someone else for the stressful experience or what
happened after it?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
to a very stressful experience. Please read each problem carefully and then
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6851", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "11. Having strong negative feelings such as fear, horror, anger, guilt, or shame?",
select one of the numbers below to indicate how much you have been bothered by
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6852", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "12. Loss of interest in activities that you used to enjoy?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
"columns": 1,
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6853", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "13. Feeling distant or cut off from other people?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
"choices":[
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
"restartDays": 2,
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "q6854", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "14. Trouble experiencing positive feelings (for example, being unable to feel
happiness or have loving feelings for people close to you)?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6855", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "15. Irritable behavior, angry outbursts, or acting aggressively?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6856", "type": "ChoiceQuestion", "required": false, "inline": true,
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
"text": "16. Taking too many risks or doing things that could cause you harm?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6857", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "17. Being \u0022superalert\u0022 or watchful or on guard?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
]},
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6858", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "18. Feeling jumpy or easily startled?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
{"id": "q6842", "type": "ChoiceQuestion", "required": false, "inline": true,
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
"text": "2. Repeated, disturbing dreams of the stressful experience?",
]},
{"id": "q6859", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "19. Having difficulty concentrating?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6860", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "20. Trouble falling or staying asleep?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
to a very stressful experience. Please read each problem carefully and then
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]}]
}
"printTitle": "PCL-5 PTSD Checklist from DSM-5",
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
"content":[
{"id": "q6843", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "3. Suddenly feeling or acting as if the stressful experience were actually
happening again (as if you were actually back there reliving it)?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "i1772", "type": "IntroText",
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6844", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "4. Feeling very upset when something reminded you of the stressful experience?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
"text": "<strong>Instructions:</strong> Below is a
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6845", "type": "ChoiceQuestion", "required": false, "inline": true,
list of problems that people sometimes have in response to a very stressful
"text": "5. Having strong physical reactions when something reminded you of the stressful
experience (for example, heart pounding, trouble breathing, sweating)?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
experience. Please read each problem carefully and then select one of the
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6846", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "6. Avoiding memories, thoughts, or feelings related to the stressful experience?",
"intro": "<strong>Instructions:</strong> Below is a list of problems that people sometimes have in response
to a very stressful experience. Please read each problem carefully and then
select one of the numbers below to indicate how much you have been bothered by
that problem <u>in the past month</u>.<br /><br /><strong>In the past month, how much were you bothered by:</strong>",
numbers below to indicate how much you have been bothered by that problem <u>in the
"columns": 1,
"choices":[
{"id": "c212", "text": "0. Not at all", "quickKey": 0},
{"id": "c684", "text": "1. A little bit", "quickKey": 1},
{"id": "c685", "text": "2. Moderately", "quickKey": 2},
{"id": "c686", "text": "3. Quite a bit", "quickKey": 3},
{"id": "c687", "text": "4. Extremely", "quickKey": 4}
]},
{"id": "q6847", "type": "ChoiceQuestion", "required": false, "inline": true,
"text": "7. Avoiding external reminders of the stressful experience (for example, people,
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