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Before you begin

Think about the traumatic event previously identified as most distressing. The P items ask about the past month; the C items ask how you typically feel, think about yourself, and relate to others.

Clinical checks appear only after a response of Moderately or higher. You may pause or stop at any time. This tool cannot diagnose PTSD or CPTSD or assess immediate safety.

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Answer review
Primary Care PTSD Screen (PC-PTSD-5) Check a lifetime trauma gate and five past-month PTSD symptoms, then see how the 0–5 PC-PTSD-5 score compares with 3+ and 4+ cut points.
Posttraumatic Stress Disorder Checklist (PCL-5) Assessment Complete the 20-item past-month PCL-5, see the 0 to 80 total and DSM-5 cluster counts, and review screening cut points with safety context.
Depression Anxiety Stress Scales (DASS-21) Assessment Complete the DASS-21 for the past week and review doubled Depression, Anxiety, and Stress scores with exact severity bands and safety context.
Kessler Psychological Distress Scale (K10) Assessment Measure distress frequency over the past four weeks with K10, compare two published band guides, and review the complete response pattern.

Trauma reactions are easy to misunderstand when a short phrase can describe both an ordinary response and a clinically important symptom. Feeling watchful after a frightening event, for example, is not automatically the same as repeatedly feeling in danger. The International Trauma Questionnaire with Clinical Checks (ITQ-CC) adds focused follow-up questions to clarify the intended frequency, intensity, meaning, or life impact of an endorsed symptom.

The measure covers the two ICD-11 post-traumatic stress disorder (PTSD) symptom clusters and the disturbances in self-organization (DSO) associated with complex PTSD (CPTSD). PTSD content addresses re-experiencing, avoidance, a continuing sense of threat, and related impairment. DSO content addresses difficulty regulating emotion, negative self-concept, relationship disturbance, and related impairment.

Dimensional totals
Two 0 to 24 totals summarize the six PTSD symptom ratings and the six DSO symptom ratings. Higher totals mean greater reported symptom burden, but the ITQ-CC defines no severity cutoff for either total.
Clinical checks
A base rating of Moderately or higher opens its follow-up check. The check decides whether that response counts in the categorical criterion trace.
Functional impairment
Separate items ask about disruption to relationships, work, study, parenting, and other important activities. A follow-up check confirms whether the disruption is serious and ongoing.

Clinical checks aim to reduce endorsements caused by a different interpretation of the original wording. They do not turn self-report into a clinical interview, and research on the checks has not established agreement with interview diagnosis. Trauma exposure, duration, alternative explanations, current safety, culture, and professional judgment still matter.

The result is a screening and algorithm trace, not a diagnosis of PTSD or CPTSD. A person may also need support when the categorical requirements are not met, especially when symptoms or impairment are distressing.

How to Use This Tool:

Use the most distressing previously identified traumatic event as the reference. The PTSD items use the past month, while the DSO items ask about typical experience.

  1. Select Start ITQ-CC only when it is safe to reflect on the event. Pause or stop if the questions become too distressing.
  2. Rate each base item from Not at all to Extremely. A rating of Moderately, Quite a bit, or Extremely opens the associated clinical check.
  3. Answer every clinical check that appears. A base rating at or above Moderately does not count toward a categorical criterion unless the corresponding check is answered Yes.
  4. Finish the assessment, then read the provisional algorithm result beside the PTSD symptom total, DSO symptom total, and criterion trace. Use Edit answers if a response does not match the intended recall period or meaning.

Interpreting Results:

Read the categorical trace and the dimensional totals together. PTSD requirements met means that the checked endorsements cover re-experiencing, avoidance, current threat, and PTSD-related impairment. CPTSD requirements met additionally requires all three DSO clusters and DSO-related impairment. The algorithm reports CPTSD rather than a second, simultaneous PTSD label when both sets are present.

  • A higher PTSD or DSO total means more reported symptom burden on its 0 to 24 scale. It does not identify a mild, moderate, or severe band.
  • A base rating can increase a dimensional total even when its clinical check is No. That difference is intentional.
  • A result below the categorical requirements does not rule out distress, impairment, another trauma-related condition, or a need for support.
  • Clinical decisions require trauma history, timing, exclusions, differential diagnosis, functioning, and a direct safety assessment.

Technical Details:

There are 18 base items: six PTSD symptoms, three PTSD impairment items, six DSO symptoms, and three DSO impairment items. Base responses score 0 through 4. Twelve symptom checks and two grouped impairment checks are conditionally administered, producing as many as 32 recorded response slots.

Formula Core

The dimensional scores sum only the six symptom ratings in their respective domains. Clinical-check responses do not change these totals.

PTSD total = ∑i=16 Pi , 0≤Pi≤4 DSO total = ∑i=16 Ci , 0≤Ci≤4

Each total therefore ranges from 0 to 24. No weighting, reverse scoring, averaging, or rounding is applied.

Rule Core

A symptom check appears only when its base item is 2 or higher. The grouped impairment check appears when at least one of its three impairment ratings is 2 or higher. An applicable check contributes a confirmed endorsement only when its answer is Yes.

Requirement set All required checked criteria Algorithm result
PTSD At least one re-experiencing check, one avoidance check, one current-threat check, and the PTSD impairment check Provisional PTSD requirements when the DSO set is incomplete
DSO At least one affective-dysregulation check, one negative-self-concept check, one relationship-disturbance check, and the DSO impairment check Provisional CPTSD requirements only when the full PTSD set is also met
Neither One or more required PTSD criteria are absent Requirements not met, regardless of the dimensional totals

All applicable items must be complete before scoring. A skipped conditional check is represented as not asked only when its base response is below 2; it is not interchangeable with a No answer to an applicable check.

Limitations, Safety, and Privacy:

The ITQ-CC cannot confirm trauma exposure, establish a diagnosis, rule out other conditions, or assess immediate danger. Seek qualified support when trauma symptoms cause distress or impairment. For current danger, inability to stay safe, or thoughts of self-harm, use local emergency or crisis services rather than relying on this questionnaire.

Answers stay in the current browser tab and are not placed in the URL or sent to a server. Reloading or starting a new session clears them. Downloaded reports and copied data leave that private session, so store or share them only with appropriate consent.

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