Post-Traumatic Stress Disorder: How Can PTSD Self-Assessment Tests Help You Recognize The Symptoms?

If you're here, I assume you're here because you want to know if it's possible to (at least tentatively) self-diagnose post-traumatic stress disorder, probably using online self-assessment tests. Or, of course, to amateur-diagnose someone you care about and whom you suspect to suffer from PTSD after they lived through a traumatic event. You may also want to know which screening tests to use.

The "too long; didn't read" version of the answer would be:

"Screening tests for PTSD can determine whether someone has PTSD symptoms quite accurately, but there are other factors at play that mean that self-diagnosing PTSD is ultimately often a bad idea. Most people should use self-assessments only to help them figure out whether they are likely to have PTSD and need professional help. But if you suspect you have PTSD, you could probably benefit from that help anyway."

Now, let's get into the longer version. We'll take a look at whether people with PTSD are likely to realize they have the trauma-related anxiety disorder, what role self-screening quizzes for PTSD can play on someone's path to treatment, and what screening tests are used. We'll also tackle what to do if you think you've got post-traumatic stress disorder. 

Do people with PTSD after a traumatic event tend to realize they have the disorder?

As a loyal "netizen" (internet citizen"), I don't doubt that you'll have come across people claiming to suffer from post-traumatic stress disorder after their bunny passed away in a completely non-violent way after a long and presumably happy life. (I didn't make that one up. Someone on a forum I participated in actually shared that story.) While most of those people are probably being hyperbolic and are quite aware they don't actually have PTSD, a sad few of those people will be completely serious. 

Research conducted among law enforcement officers involved in shooting incidents in a country where gun violence is rare, on the other hand, shows that many officers who were found to meet the diagnostic criteria for post-traumatic stress disorder didn't realize they were dealing with PTSD. Indeed, both they and their bosses had noticed that their performance was negatively affected following the traumatic event, but their bosses didn't make the link between the two, either. None of the officers with PTSD — part of a specific, masculine, work culture that doesn't exactly promote exploration of emotions — sought professional help for their symptoms before the start of the study in question. 

Those people are, perhaps, most likely to avail themselves to only self-assessments to learn more, as they try to understand what they are going through in more detail and perhaps to prepare them to see a psychologist. 

What are screening tests?

The kinds of self-assessments for PTSD you will find on the internet are screening tests. Screening is a process that can help medical professionals "catch" conditions that are currently still unrecognized. In the case of psychological screening tests, a doctor or psychologist can use these kinds of tests to assess whether a potentially at-risk person is displays any signs that they're likely to have a particular condition. 

Examples would include asking new mothers to participate in questionnaires to determine whether they could have postpartum depression, and of course screening combat veterans and domestic violence victims for PTSD. A screening test doesn't equal diagnosis, but indicates that a more thorough evaluation during which a diagnosis can be made should be pursued. 

What screening tests are used for PTSD?

Here's a recap of boxes someone must tick to be diagnosed with post-traumatic stress disorder (somewhat abbreviated!):

• Exposure to trauma — the DSM-5 highlights actual or threatened death, serious injury, or sexual violence, but other traumas, like prolonged emotional abuse or bullying, can qualify as well. This includes directly experiencing the trauma and witnessing it happen to someone else. 
• At least one so-called intrusion symptom — repeated, distressing, and intrusive memories of the event, distressing dreams, flashbacks, profound mental distress when remembering the trauma, and profound physical distress when remembering the trauma. 
• Persistent avoidance of reminders of the trauma, by avoiding external reminders like people, places, and circumstances, or internal reminders (thoughts and feelings related to the event), or both. 
• At least two symptoms that indicate a negative impact on mood and cognition — beingh unable to remember an important aspect of the trauma, exaggerated negative beliefs about the self, (unwarranted or extreme) self-blame or blame of others, a chronically negative emotional state, loss of interest in important activities, feeling detached from others or the world, and an inability to experience positive emotions. 
• At least two symptoms that show evidence of changed reactivity and arousal — irritable or angry behavior, reckless or self-destructive behavior, hypervigilance, increase startle response, trouble concentrating, and dysfunctional sleep. 
• Symptoms must last longer than a month and significantly negatively impact daily functioning. They can't be better explained by another condition or by substance abuse. 

So, screening tests for PTSD will seek to determine whether someone has these symptoms. As such, they ask questions like:

• Have you experienced something especially horrific, scary, or distressing, such as a serious accident, war, physical or sexual abuse, or seeing someone killed or seriously injured?
• Have you tried your best to avoid thinking about this event?
• Have you had nightmares about it? (One screening test adds "when you did not want to"... but who wants nightmares?)
• Have you had physical symptoms like a fast heartbeat, sweating, and dizziness when you were reminded of the event?

Screening tests used by doctors and endorsed by the US Department for Veterans Affairs are:

• The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), which includes five questions. 
• The Trauma Screening Questionnaire, which includes 10 questions. 
• The SPAN, which got its name because it looks for "startle, physically upset by reminders, anger, and numbness", a more involved assessment that allows people to indicate how severely they are affected by particular symptoms. 
• The The Short Post-Traumatic Stress Disorder Rating Interview (SPRINT), which is similar. 

If you are going to do a self-screen test, it should ideally be based on one of these screening tools. Be wary of "pop-quiz-like" internet tools. Choose reputable sources.

What role can self-assessment tests for PTSD play? Should you really self-diagnose?

Some people will warn you against self-diagnosis and believe it can never be accurate, with a few even going so far as to suggest that PTSD is now "fashionable" and people want to think they have it when they don't.

As someone who suspected they had PTSD before having it confirmed by a psychologist, I am not necessarily one of them — I believe many people who have PTSD can adequately identify the condition in themselves, though many more with PTSD will miss the signs in themselves.

Indeed, for some people who don't have access to medical treatment and formal diagnosis, this may be the only path. Further, some people who will later be ready for treatment just aren't right now, and those people could still benefit from learning more about PTSD coping mechanisms.

You'll also need to see a medical professional for formal diagnosis if you want to access treatment, and that's another good reason not to avoid this step. 

Screening tests may be a helpful stop on your path, but they shouldn't usually be your final destination. Even if these tests indicate you probably don't have PTSD, by the way, there's still no reason not to seek help if you are struggling. You may still have PTSD, or you could be dealing with another condition following a distressing event — like depression, acute stress disorder, adjustment disorder, or anxiety.