DAPS

Question Booklet
Dr John Briere Read all the instructions carefully before you begin. Mark your answers on the Answer Sheet and write only in the spaces provided. Do NOT write in this Booklet. On the Answer Sheet, write your name, age, sex, race/ethnicity and todays date in the space provided. The questionnaire describes experiences that have happened to you and such that have not. Some of the questions concern experiences which occurred at some point in your life, and others experiences which you may have had in the last month. Read each question carefully. Then choose the answer that best describes your experience by circling the number corresponding to the answer you selected. Circle 1 if your answer is Never Circle 2 if your answer is Once or twice Circle 3 if your answer is Sometimes Circle 4 if your answer is Often Circle 5 if your answer is Very often 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 4 4 4 5 5 5 5 5

For example, if during the last month you have sometimes felt disappointed by those around you, circle 3 for this question, as shown: Felt disappointed by those around. 1 2 3 4 5

If you make a mistake and wish to change your answer, DO NOT ERASE! Cross out the wrong answer with an X and then circle the correct one as shown: Felt disappointed by those around. 1 2 3 4 5

Try to answer each question honestly. Do not skip questions. You can take as much time as you need completing the DAPS test.

Part 1
Have any of the following happened to you at some point in your life, including your childhood? On the Answer Sheet, circle Yes or No. 1. An accident or crash involving a car, motorbike, airplane, ship or other vehicle, when you were seriously injured or feared you would be injured or die? 2. A hurricane, tornado, flood, earthquake, explosion, or fire, when you were seriously injured or feared you would be injured or die? 3. An accident at work or at home, when you were seriously injured or feared you would be injured or die? 4. Someone hitting, choking or beating you (including someone you lived with or were married to), when you were seriously injured or feared you would be injured or die (at some point in your life, including your childhood)? 5. Someone threatening to hurt you or do something sexual to you against your will, although they did not actually do anything, when you feared you would be injured or die? 6. Someone shooting at you or stabbing you, or trying to shoot or stab you, when you were seriously injured or feared you would be injured or die? 7. Taking part in military action when you were seriously injured or feared you would be injured or die? 8. Being assaulted, mugged or robbed, when you were seriously injured or feared you would be injured or die? 9. Someone doing something sexual to you against your will (for example, rape, sexual assault, or an unwanted sexual contact) or making you do something sexual which resulted in serious injury or fear that you would be injured or die? 10. Someone doing something sexual against your will (even if you were not injured and did not fear you would be injured) before you were 16 years old? 11. Any other experience that resulted in serious injury or fear you would be seriously injured or die? 12. Seeing someone else get seriously injured or killed? 13. Has an adult hit or beat you, or in some other way hurt you physically so that you had scratches, bruises, cuts or other injuries before you were 16 years old?

The questions in the next section concern your reactions to one of the experiences you answered Yes to on this page (questions 1 to 12, excluding question 13).

14. Which of the experiences about which you answered Yes (questions 1 to 12 only) is the most troubling one for you at present?
Put a tick () in the box next to the question asking about this experience and if you can, describe it briefly in the space provided for that on the Answer Sheet. Or, if your doctor or therapist have asked you to answer these questions for a particular upsetting event, note down this event and describe it briefly (if possible) in the space provided for this on the Answer Sheet.

Now answer the remaining questions in this part bearing in mind the upsetting experience you have selected. (Circle your answers on the Answer Sheet.) 1=Not at all 2= A little 3=Somewhat 4=Quite a bit 5=Very much

15. How much fear did you feel at the worst point during this experience? 16. How helpless did you feel at the worst point during this experience? 17. How much terror did you feel at the worst point during this experience? 18. How much guilt did you feel at the worst point during this experience or soon after it? 19. How much shame or humiliation did you feel at the worst point during this experience or soon after it? 20. How much disgust did you feel at the worst point during this experience or soon after it? 21. How upset did you feel at the worst point during this experience or soon after? 22. Did you think you could die at the worst point during this experience? Did any of the following happen during this experience? (Circle your answers on the Answer Sheet.) 1=Not at all 2=A little 3=Somewhat 4=Quite a bit 5=Very much

23. Your mind went blank. 24. You left your body. 25. Things around you seemed unreal or strange. 26. Your body felt strange or seemed to change its shape and size. 27. It seemed to you as if time slowed down or speeded up. 28. You were not absolutely clear what was happening around you. 29. When did this event occur? (Circle your answer on the Answer Sheet.) 1 to 3 months prior to the present moment 3

This same day 1

More than a day ago but in the last month 2

More than 3 months ago but in the last year 4

A year or more ago 5

Part 2
How often in the last month have the following things happened to you? Answer the questions below bearing in mind the upsetting experience. (Circle your answers on the Answer Sheet.) Less than once a week 2 About once a week 3 2 or 3 times a week 4 4 or more times a week 5

Never 1

30. Upsetting thoughts or memories of this experience coming into your mind. 31. Not wanting to talk about what happened. 32. Problems concentrating or paying attention since it happened. 33. As if since it happened you have been walking around in a dream or a film. 34. Getting upset or nervous when something or someone reminded you of what happened. 35. Since it happened you have lost interest in doing things. 36. Since this experience your mind has been wandering although you need to concentrate. 37. Because of what happened you are unable to do things as well as you used to. 38. Images or thoughts of what has happened come to you and you are unable to get those out of your mind. 39. Not being able to remember the entire experience or part of it. 40. People annoy you more than before it happened. 41. Since it happened things do not seem completely real to you. 42. Feeling frightened or upset when something reminds you of the experience. 43. Feeling less connected to people than before it happened. 44. Since it happened, hearing a loud noise or something stirring near your face or body, make you flinch. 45. Problems in your relationships with others arise as a result of what happened to you. 46. Memories of what happened arise for no obvious reason. 47. You cannot feel your emotions to the extent you did before the incident. 48. It is more difficult for you to fall asleep or stay asleep than it was before it happened. 49. Since it happened you have been moving round in a daze, without even noticing some things.

How often in the last month have the following things happened to you? Answer the questions below bearing in mind the upsetting experience. (Circle your answers on the Answer Sheet.) Less than once a week 2 About once a week 3 2 or 3 times a week 4 4 or more times a week 5

Never 1

50. A memory of what happened comes to you, which is so powerful or intense as if the whole thing is repeating itself. 51. Avoiding people or places which remind you of what happened. 52. Feeling greater anxiety since that happened to you. 53. Having problems at work, at school or during social interaction because of what happened. 54. Having upsetting dreams or nightmares about what happened. 55. Trying to banish upsetting thoughts or feelings about what happened. 56. Feeling restless or on edge since it happened. 57. Since it happened there have been times when you have felt separated from your body. 58. When thinking about what happened or something/someone reminds you of it, your heart starts pounding, you break into a sweat or your breathing becomes laboured. 59. Not being able to feel your emotions to the extent you could before it happened. 60. Since it happened there have been times when you were so agitated that you could not relax. 61. Being unable to do the things you need to do because of what happened to you. 62. Feeling as if you are going through the experience again although you are not. 63. Not doing certain things because they remind you of what happened. 64. Have been on the lookout for dangers since it happened. 65. Since it happened you have had more problems in your life. 66. When something reminds you of what happened or you remember it, you feel dizzy or experience other bodily reactions. 67. Since it happened you feel you have no future. 68. Since it happened sudden noises or movements have been startling you.

Part 3
The remaining questions concern thoughts, feelings or experiences which you have had during the past month. Most people have experienced at least some of these things. However, some of them may sound unusual to you. Try to answer each question honestly. (Circle your answers on the Answer Sheet.) Indicate how often each of the following things has happened to you during the past month.

Never 1

Once or twice 2

Sometimes 3

Often 4

Very often 5

69. Problems in your relationships with people. 70. More than three alcoholic drinks a day. 71. Seeing flickering blue and green lights when you close your eyes. 72. Wishing you could die and not have any more problems or experience pain. 73. Taking PCP, LSD or another hallucinogen. 74. Suicidal thoughts crossing your mind. 75. Eating or drinking more than you should. 76. Using heroin or cocaine. 77. Nearly attempting suicide but stopping, because you got scared or because it would have hurt too much. 78. Not sleeping for a week or more. 79. Feeling that the use of drugs is beginning to take control of your life. 80. Having suicidal fantasies. 81. Absent-mindedness or failing memory. 82. An urge to strip off in a public place. 83. Using stimulants or sedatives to feel good. 84. Making a plan how to commit suicide. 85. Having negative thoughts about a friend of yours. 86. Losing vision for several minutes at a time. 87. Using marijuana or hashish. 88. Thinking about how to kill yourself.

Indicate how often each of the following things has happened to you during the past month.

Never 1

Once or twice 2

Sometimes 3

Often 4

Very often 5

89. Feeling jealous or envious of someone. 90. Suddenly losing your ability to read. 91. Worrying you may have a drinking problem. 92. Threatening to commit suicide. 93. Feeling hopeless. 94. Not being able to remember things you did while drinking. 95. Feeling threatened by certain kinds of music. 96. Doing something dangerous in the hope that it might kill you (for example, driving too fast or taking great risks). 97. Your drinking getting you into trouble. 98. Expecting people to treat you badly. 99. Reading peoples minds. 100. Wanting to put an end to your life. 101. Being told that you drink too much. 102. Criticizing yourself. 103. Selling all your property. 104. Attempting suicide.