Chapter 11 Early Trauma Inventory Self Report Survey
The Early Trauma Inventory Self Report Survey asked the following questions:
- Were you every exposed to a life-threatening natural disaster?
- Were you involved in a serious accident?
- Did you ever suffer a serious personal injury or illness?
- Did you ever experience the death or serious illness of a parent or primary caretaker?
- Did you experience the divorce or separation of your parents?
- Did you experience the death or serious injury of a sibling?
- Did you experience the death or serious injury of a friend?
- Did you ever witness violence towards others, including family members?
- Did anyone in your family ever suffer from mental health or psychiatric illness or have a “breakdown”?
- Did your parent or primary caretaker have a problem with alcoholism or drug or drug abuse?
- Did you ever see someone murdered?
- Were you ever slapped in the face with an open hand?
- Were you every burned with hot water, a cigarette or something else?
- Were you ever punhed or kicked?
- Were you ever hit with an object that was thrown at you?
- Were you ever pushed or shoved?
- Were you often put down or ridiculed?
- Were you often ignored or made to feel that you didn’t count?
- Were you often told that you were no good?
- Most of the time were you treated in a cold, uncaring way or made to feel like you were not loved?
- Did your parents or caretakers often fail to understand you or your needs?
- Were you ever touched in an intimate or private part of your body (e.g. breast, thighs, genitals) in a way that surprised you or made you feel uncomfortable?
- Did you ever experience someone rubbing their genitals against you?
- Were you ever forced or coerced to touch another person in an intimate or private part of their body?
- Did anyone ever have genital sex with you against your will?
- Were you ever forced or coerced to perform oral sex on someone against your will?
- Were you ever forced to kiss someone in a sexual rather than affectionate way?
- Did you ever experience emotions of intense fear, horror, or helplessness?
- Did you ever feel out-of-your-body or as if you were in a dream?
More information on the Early Trauma Inventory Self Report Survey (ETISR-SF): http://onlinelibrary.wiley.com/doi/10.1002/1520-6394(2000)12:1%3C1::AID-DA1%3E3.0.CO;2-W/full