CE Disabled Services Dr Clyde Shideler, Director P.O. Box 495 San Luis Rey, CA 92068 cedisabl@sprynet.com TO: PTSD Study Volunteers, IMPORTANT: PLEASE READ THIS LETTER, FIRST, AND FOLLOW THE INSTRUCTIONS IN IT AND THOSE IN THE "QUESTIONAIRE" This questionaire is a "self assessment" questionaire and as such when completed, you should be able to decide and know if you do have Post-Traumatic Stress Disorder. If you feel you have PTSD and have not already had an official diagnosis of PTSD by a doctor, I would suggest you contact your personal doctor, discuss it with him/her and provide him/her with a copy of the completed or incomplete questionaire. If a problem arises during work on the questionaire, do not work on it further, notify and discuss this, IMMEDIATELY, with your personal doctor. At any time you may, also, decline to continue with this study. Please forward the completed or incomplete questionaire to me. I will assign each questionaire a number and your name and address information will be removed so that those reviewing it will not know your name. I will keep the master file of the names and numbers and will be the only person to know your name and address information. If those reviewing the questionaires feel you have PTSD, I will notify you so that you, if needed, can then make arrangements with your personal doctor. When all material has been compiled, a final report about the study will be written and this, too, shall be sent to you, if you have requested it. The page titled "WARNING SIGNS" should be read first after this letter and please, abide by those instructions. I would recommend that you have a family member or close friend available while doing the questionaire that you can call or talk to, should a problem arise. Remember it is important to stop work immediately, and do no more work on the questionaire, if a problem does arise. The "Warning Signs" page and the entire "Self Assessment Questionaire" are from the book "Post-Traumatic Stress Disorder, A Complete Treatment Guide" By Aphrodite Matsakis, Ph.D. Published by New Harbinger Publications, Inc. in 1994 Permission was granted for their use by the author. You may wish to read this book or get others on PTSD at your local library. The "Support Group List" lists available PTSD support group list. This "questionaire" will, also, be available on the following web sites. http//:www.cfids-me.org/ http//:www.aloha.net/~cwburch/ http//:www.deafwatch.com http//:home.earthlink.net/~dawnn/ http//:members.tripod.com/~barbara_robertson/DisRes.html Thank you for your assistance in this study. Dr Clyde Shideler The following information is optional, but requested for contact purposes only. You may answer all or parts. ______________________________________________ ______________________ Name Number ______________________________________ _______________________ Address Disability _______________________________________ _______________________ City, State, Zip Code I have PTSD diagnosis by a Doctor _______________________________________ (yes or no) Telephone Number and/or E-mail address POSSIBLE SUPPORT GROUP LIST: The first group I'd check is alt.support.trauma-ptsd. Other groups might be good depending upon the source of the trauma. Veterans groups: soc.veterans, alt.war.vietnam sexual abuse: alt.sexual.abuse.recovery, (there is a new moderated version of this group that I'd recommend over the unmoderated version) sexual or physical abuse: alt.support.dissociation (which, according to DejaNews, deals with PTSD more than asar or most other groups except ast-ptsd and the veterans groups), alt.abuse.recovery (more direct, open confrontation than asd or asar) alt.support.anxiety-panic for dual dx: alt.recovery.aa PTSD and Americans with Disabilities Act: bit.listserv.ada-law Our list is: PTSD@MAELSTROM.STJOHNS.EDU. and a subscription should be sent to: LISTSERV@MAELSTROM.STJOHNS.EDU. WARNING SIGNS The symptoms listed here are among those to watch for. As you work to heal from your trauma, both in sessions or outside, you need to monitor your reactions. This work includes talking to your counselor/doctor, doing writing or other exercises about the traumatic events you experienced or the aftereffects, emotional effects, or subsequent related events. If you experience any of the followng symptoms while doing such work (or at any other time) stop what you are doing immediately and talk to your counselor/doctor or another mental health professional or even a close friend. 0 Hyperventilation (uncontrollable gasping for air or rapid breathing), uncontrollable shaking, or irregular heartbeat 0 Feelings that you are losing touch with reality, even temporarily, for instance, having hallucinations or extreme flashbacks of the event 0 Feeling disoriented, spaced out, unreal, or as if you might be losing control 0 Extreme nausea, diarrhea, hemorrhaging, or other physical problems, including intense, new, or unexplainable pains or an increase in symptoms of a preexisting medical problem, for example, blood sugar problems if you are diabetic 0 A desire to hurt yourself 0 Self-destructive behavior such as alcohol or drug abuse, self-induced vomiting, or overspending 0 Suicidal or homicidal thoughts 0 Memory problems Also call for help if you are having so much emotional pain, anxiety, or anger that you fear you are going to die. Mild anxiety is a normal reaction, but extreme anxiety or despair needs professional attention as soon as possible. if you are unable to contact your counselor/doctor and are truly frightened, go to the emergency room of a local hospital. Meanwhile, do the following: 0 Focus on something besides the trauma. 0 Touch a physical object (a wall, a chair, whatever is nearby). 0 Talk to someone right away. 0 Avoid isolating yourself or taking alcohol, drugs, or other mood-altering substances. 0 If you are angry, try expressing it in a safe way, such as talking to a trusted friend, punching a pillow, or tearing up a telephone directory. 0 Do something pleasurable and relaxing: Take a hot bath, go for a long walk, listen to favorite music, pet the cat. Even if you feel certain you do not need professional help, if you experience any of the reactions listed above, take a break from trauma work and follow one of these suggestion. This includes any work on this questionaire. Keep in mind that having a strong reaction to thinking about the trauma or otherwise working on healing does not make you a failure. Developing symp- toms as a result of being in therapy does not reflect an inability to heal or a hidden unwillingness to heal. Instead, your reactions probably reflect the degree of traumatization you endured, which was not under your control. Your reactions have nothing to do with your strength of character. ( Email to Dr. Clyde Shideler at cedisabl@sprynet.com )