Trauma Study

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LEC5_Standard_Self-report.PDF
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Life Events Checklist for DSM-5 (LEC-5)

Standard Version

Version date: 12 April 2018

Reference: Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013). The Life Events Checklist for DSM-5 (LEC-5) – Standard. [Measurement instrument]. Available from https://www.ptsd.va.gov/

URL: https://www.ptsd.va.gov/professional/assess- ment/te-measures/life_events_checklist.asp

Note: This is a fillable form. You may complete it electronically.

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Page 1 of 1LEC-5 Standard (12 April 2018) National Center for PTSD

LEC-5 Standard

Instructions: Listed below are a number of difficult or stressful things that sometimes happen to people. For each event check one or more of the boxes to the right to indicate that: (a) it happened to you personally; (b) you witnessed it happen to someone else; (c) you learned about it happening to a close family member or close friend; (d) you were exposed to it as part of your job (for example, paramedic, police, military, or other first responder); (e) you’re not sure if it fits; or (f) it doesn’t apply to you.

Be sure to consider your entire life (growing up as well as adulthood) as you go through the list of events.

Event Happened to me Witnessed

it Learned about it

Part of my job

Not sure

Doesn’t apply

1. Natural disaster (for example, flood, hurricane, tornado, earthquake)

2. Fire or explosion

3. Transportation accident (for example, car accident, boat accident, train wreck, plane crash)

4. Serious accident at work, home, or during recreational activity

5. Exposure to toxic substance (for example, dangerous chemicals, radiation)

6. Physical assault (for example, being attacked, hit, slapped, kicked, beaten up)

7. Assault with a weapon (for example, being shot, stabbed, threatened with a knife, gun, bomb)

8. Sexual assault (rape, attempted rape, made to perform any type of sexual act through force or threat of harm)

9. Other unwanted or uncomfortable sexual experience

10. Combat or exposure to a war-zone (in the military or as a civilian)

11. Captivity (for example, being kidnapped, abducted, held hostage, prisoner of war)

12. Life-threatening illness or injury

13. Severe human suffering

14. Sudden violent death (for example, homicide, suicide)

15. Sudden accidental death

16. Serious injury, harm, or death you caused to someone else

17. Any other very stressful event or experience

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