If you would like to receive the results, please fill out the following:
-Physical problems such as headache, stomachache, dizziness, nausea, diarrhea, and tremors:
-Experiences excessive anxiety:
-Lacks confidence in abilities
-Requires a lot of reassurance:
-Needs everything to be perfect:
-Appears shy or hesitant:
-Is sensitive to criticism:
-Bites nails:
-Has fears and phobias:
-Refuses to go to school:
-Difficulty separating from parent(s)
-Has excessive need for checking, counting, washing, cleaning, organizing, or night outs:
-Is afraid of sleep/does not sleep in their own bed
-Has sleep problems:
-Displays frequent anger:
-Has muscle tension/cannot relax:
-Has a accelerate heart rate/difficulty breathing:
-Sweats:
-Feels chills/hot flashes:
-Experiences chest pain:
-Has difficulty forming friendships and maintaining friends:
-Has difficulty listening to teachers:
-Breaks possessions or harms animals:
-Doesn't feel guilt:
-Has problems with the law:
-Repeated and distressing thoughts of a past traumatic event:
-Repeated and distressing dreams of a past traumatic event:
-Feeling as if the traumatic event is happening again (reliving the traumatic event):
-Feeling panic or fear of events resembling the traumatic event:
-Inability to remember an important aspect of the traumatic event:
-Avoiding people, places, activities, or situations that trigger memories of the traumatic event:
-Blaming oneself for what happened:
-Feeling detached or distant from others:
-Numbness or restriction of emotions:
-Quick startle response to any stimulus (jumps at any stimulus):
