Name Age `Date of Birth I.D.# CHILDREN S IMPACT OF TRAUMATIC EVENTS SCALE-REVISED. Vicky Veitch Wolfe and Carole Gentile
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1 Name Age `Date of Birth I.D.# Boy or Girl (circle which) CHILDREN S IMPACT OF TRAUMATIC EVENTS SCALE-REVISED Vicky Veitch Wolfe and Carole Gentile The University of Western Ontario TO INTERVIEWER: Record the recent event(s) that comprised the victimisation. Include information regarding the perpetrator, what happened, when and where the event(s) took place, and any other circumstantial information deemed important. Prior to presenting this questionnaire, read the following instructions to the child: I am going to ask you several questions about what happened between you and (perpetrator). I am going to ask you to describe what happened, instead, I want to know YOUR thoughts and feelings about what happened. I will read a sentence and you can tell me whether or not it is very true, somewhat true, or not true. There are no right or wrong answers to the questions I will be asking. Some of the questions may cause you to remember things that were unpleasant. If you feel very uncomfortable answering any question, let me know, and I can move on to another question. SCALES: PTSD Attributions about abuse IT Intrusive Thoughts SB-GU Self Blame/Guilt AV Avoidance PV Personal Vulnerability HYP-AR Hyperarousal DW Dangerous World SX-A Sexual Anxiety EMP Empowerment Social Reactions Eroticism NRO Negative Reactions by others ERO Eroticism SS Social Support
2 1. Things like this WILL happen again (EMP) 2. Some people believe that I did a very bad thing (NRO) 3. I try to stay away from things that remind me of what happened. (AV) 4. People who know about what happened think bad thoughts about me (NRO) 5. Some people blame me for what happened. (NRO) 6. I often feel irritable for no reason at all. (Hyp-AR) 7. I have trouble falling asleep because pictures or thoughts of what happened keep popping into my head. (IT) 8. I dislike or feel uncomfortable spending time alone with older boys or men. (PV) 9. If adults bother me, I can stop them. (EMP) 10. These kinds of things happen often. (PV) 11. I have dreams or nightmares about what happened. (IT) 12. I have difficulty concentrating because I often think about what happened. (Hyp-AR) 13. This happened to me because I was too young to do anything about it. (SB-GU) 14. After people learned about what happened, they no longer wanted to spend time with me. (NRO) 15. Something like this might happen to me again. (PV)
3 16. I was to blame for what happened. (SB-GU) 17. People often take advantage of children. (DW) 18. I am easily startled or surprised. Hyp-AR) 19. These kinds of things happen to a lot of children. (DW) 20. I think about what happened to me even when I don t want to. (IT) 21. I was not to blame for what happened. (SB-GU) (reverse) 22. This happened to me because I acted in a way that caused it to happen. (SB-GU) 23. Pictures of what happened often pop into my mind. (IT) 24. I often feel restless or jumpy. (Hyp-AR) 25. Things in my life will get better. (EMP) 26. Some kids at school make fun of me because of what happened. (NRO) 27. Most people who know about what happened are nice and understanding. (SS) 28. I feel I have caused trouble to my family. (SB-GU) 29. Some people think I am lying about what happened. (NRO) 30. I am easily annoyed by others. (Hyp-AR) 31. This happened to me because I was not smart enough to stop it from happening. (SB-GU) 32. I try not to think about what happened. (AV) 33. Most people believe me when I talk about what happened. (SS)
4 34. I think about sex even when I don t want to. (ERO) 35. This happened to me because I was bad and needed to be punished. (SB-GU) 36. I sometimes have trouble remembering what happened during the sexual abuse. (AV) 37. I am embarrassed when I see people who know what happened. (SB-GU) 38. There are many people who do bad things to children. (DW.) 39. I feel I have caused problems for many people. (SB-GU) 40. I feel guilty about what happened. (SB-GU) 41. Thinking about sex upsets me. (SX-A) 42. Sometimes when playing, I act out what happened during the sexual abuse. (IT) 43. This happened to me because I always have bad luck. (PV) 44. I get frightened when I think about sex. (SX-A) 45. As a result of what happened, people who used to care about me no longer do. (NRO) 46. I have more sexual feelings than my friends. (ERO) 47. (PERPETRATOR) was to blame for what happened. (SB-GU) (reverse) 48. When I am reminded of what happened, I sometimes feel very scared. (Hyp-AR) 49. If something like this happens again, I CAN stop it. (EMP)
5 50. I sometimes want to cry when I think of what happened. (IT) 51. Some people think that I was to blame for what happened. (NRO) 52. No matter what I do, I can t stop sexual abuse. (PV) 53. If something like this happens again, I think I KNOW what to do to stop it. (EMP) 54. I am not as interested in some things I used to like before the sexual abuse happened. (AV) 55. People who I trusted let me down. (NRO) 56. Many things remind me of what happened. (IT) 57. I feel I should be punished for what I did. (SB-GU) 58. When I m reminded of what happened, I try to think of something else. (AV) 59. I worry that other children will also be sexually abused. (DW) 60. Things like this happen to only a few children. (PV) (reverse) 61. I know enough about sexual abuse now that I can protect myself in the future. (EMP) 62. I often worry that I will be sexually abused again. (PV) 63. I have someone with whom I feel comfortable talking about the sexual abuse. (SS) 64. Sex is dirty. (SX-A)
6 65. I like to look at naked people in books or on tv. (ERO) 66. I have tried to forget about what happened. (AV) 67. Children should not trust adults because they might sexually abuse them. (DW) 68. My family will protect me from being sexually abused again. (EMP) 69. I hope I never have to think about sex again. (SX-A) 70. I feel good about how my family treated me after I told about the sexual abuse. (SS) 71. I feel I have to know people for a long time before I can trust them. (PV) 72. I sometimes have sexual feelings when I see people kiss on TV (ERO) 73. I sometimes pretend this never happened or that it was a bad dream. (AV) 74. Since people found out about the sexual abuse, they have tried to protect me from it happening again. (SS) 75. I wish there was no such thing as sex. (SX-A) 76. Social workers, police, and/or doctors have helped me since I told about the sexual abuse (limit question to those professionals with whom the child has had contact). (SS) 77. It is more difficult for me to love people than it was before the sexual abuse. (AV) 78. Bad things happen to be all the time. (PV)
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