Peritraumatic Dissociative Experiences Questionnaire

Please complete the items below by circling the choice that best describes your experiences and reactions during the attack and immediately afterwards. If an item does not apply to your experience, please circle “not at all true”.

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5

Not at all true

Slightly true

Some-what true

Very true

Extremely true

Q1

I had moments of losing track of what was going on—I “blanked out” or “spaced out” or in some way felt that I was not part of what was going on

Q2

I found that I was on “automatic pilot”—I ended up doing things that I later realized I hadn’t actively decided to do.

Q3

My sense of time changed—things seemed to be happening in slow motion.

Q4

What was happening seemed unreal to me, like I was in a dream or watching a movie or play.

Q5

I felt as though I were a spectator watching what was happening to me, as if I were floating above the scene or observing it as an outsider.

Q6

There were moments when my sense of my own body seemed distorted or changed. I felt disconnected from my own body, or that it was unusually large or small.