Designing a Survey
Design a survey to gather data about your topic of interest. The survey should contain at least 10 items.
Example Survey Questions PTSD
Sometimes things happen to people that are unusually or especially frightening, horrible, or traumatic. For example:
Have you ever experienced this kind of event?
YES / NO
If no, screen total = 0. Please stop here.
If yes, please answer the questions below.
In the past month, have you…
Prins, A., Bovin, M. J., Kimerling, R., Kaloupek, D. G., Marx, B. P., Pless Kaiser, A., &Schnurr, P. P. (2015). The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). [Measurement instrument].
|Yes No||You have experienced or witnessed a life-threatening event that caused intense fear, helplessness, or horror.|
Do you have intrusions about the event in at least one of the following ways?
|Yes No||Repeated, distressing memories, or dreams|
|Yes No||Acting or feeling as if the event were happening again (flashbacks or a sense of reliving it)|
|Yes No||Intense physical and/or emotional distress when you are exposed to things that remind you of the event|
Do you avoid things that remind you of the event in at least one of the following ways?
|Yes No||Avoiding thoughts, feelings, or conversations about it|
|Yes No||Avoiding activities and places or people who remind you of it|
Since the event, do you have negative thoughts and mood associated with the event in at least 2 of the following ways?
|Yes No||Blanking on important parts of it|
|Yes No||Negative beliefs about oneself, others and the world and about the cause or consequences of the event|
|Yes No||Feeling detached from other people|
|Yes No||Inability to feel positive emotions|
|Yes No||Persistent negative emotional state|
Are you troubled by at least two of the following?
|Yes No||Problems sleeping|
|Yes No||Irritability or outbursts of anger|
|Yes No||Reckless or self-destructive behavior|
|Yes No||Problems concentrating|
|Yes No||Feeling “on guard”|
|Yes No||An exaggerated startle response|
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing
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