Peritraumatic Dissociation Questionnaire Test - the question form

Questions: 9 · 2 minutes
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Male form
Female form
1. Were there moments during the event when you stopped understanding what was happening? Did you feel as if things were not real or as if you were "out of touch with reality"? Were there other times when you did not feel part of what was going on?
Entirely false
Sometimes true
Somewhat true
True
Entirely true
2. Did you act automatically, as if on “autopilot,” without consciously intending to do what you were doing at the time?
Completely false
Sometimes true
True to some extent
True
Completely true
3. Did your sense of time change? Did it seem as if events were speeding up or slowing down?
Not at all true
Sometimes true
Somewhat true
True
Entirely true
4. Did things seem unreal to you, as if you were in a dream or watching a movie or some kind of performance?
Not true at all
Sometimes true
Somewhat true
True
Very true
5. Did you feel like an outside observer of what was happening to you? Did you feel as if you were floating above the scene or watching it from a distance?
Completely false
Sometimes true
Somewhat true
True
Completely true
6. Did your sense of your own body feel distorted or changed (for example, feeling unusually small or large), or did you feel detached from your body?
Completely untrue
Sometimes true
Somewhat true
True
Completely true
7. Did it seem as though something happening to someone else was happening directly to you?
Completely untrue
Sometimes true
Somewhat true
True
Completely true
8. After it was over, were you surprised to find that many things had happened in your presence that you did not know about (especially things you would normally have noticed)?
Completely untrue
Sometimes true
Somewhat true
True
Completely true
9. If you were injured during the event, did you notice that at the moment of injury you felt surprisingly little pain or no pain at all? (If you were not injured, choose the first answer.)
Not at all true
Sometimes true
Somewhat true
True
Completely true
1. During the event, were there moments when you stopped understanding what was happening—felt a loss of reality or as if you were “not in reality,” or otherwise felt detached from what was going on?
Completely untrue
Sometimes true
Somewhat true
True
Completely true
2. Did you act automatically ("on autopilot"), so that after doing something you later realized you had done it, but at the time you had no deliberate intention to do it?
Not at all true
Sometimes true
Somewhat true
True
Completely true
3. Did your sense of time change? Did it seem as if events were happening much faster or much slower than usual?
Not true at all
Sometimes true
Somewhat true
True
Very true
4. Did what was happening seem unreal to you, as if you were in a dream or watching a movie or some kind of show?
Completely untrue
Sometimes true
Somewhat true
True
Completely true
5. Did you feel like an outside observer of what was happening to you? Did it feel as if you were floating above the scene or watching it from a distance?
Completely false
Sometimes true
True to some extent
True
Completely true
6. Did your sense of your own body feel distorted or changed (for example, feeling unusually small or large), or did you feel disconnected from your body?
Not at all true
Sometimes true
Somewhat true
True
Completely true
7. Did it seem as if something happening to someone else was happening directly to you (for example, if you saw someone injured, did you feel as if you were the one injured, even though you were not)?
Completely untrue
Sometimes true
True to some extent
True
Completely true
8. After it was over, were you surprised to find that a lot had happened in your presence that you did not know about (especially things you would usually notice)?
Completely untrue
Sometimes true
Somewhat true
True
Completely true
9. If you were injured during the event, did you notice that at the moment of injury you felt surprisingly little pain, or no pain at all? (If you were not injured, select the first response.)
Completely false
Sometimes true
Somewhat true
True
Completely true
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