ptsd html
<html>
<head>
<link rel="stylesheet" type="text/css" media="print" href="${oscar_image_path}JSMPC.css" />
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<script language="javascript" type="text/javascript">
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startup functions
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function startUp()
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setDocumentTitle('PTSD Scale',document.getElementById('PtName').value);
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submit and print functions
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checkbox functions
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<script type="text/javascript" language="javascript">
function CriteriaAScore(){
if ((document.getElementById("Life").value == '') || (document.getElementById("SeriousInj").value == '') || (document.getElementById("IntegrityThreat").value == '') || (document.getElementById("IntenseFear").value == ''))
{document.getElementById("CriteriaA").value = 'NO';
alert("Please designate Yes or No in sections 1 and 2.");
return false;
}
var i = 0
if (document.getElementById("Life").value == 'N'){i += 0;}
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if (document.getElementById("SeriousInj").value == 'N'){i += 0;}
else {i += 1;}
if (document.getElementById("IntegrityThreat").value == 'N'){i += 0;}
else {i += 1;}
if (i == 0 || (document.getElementById("IntenseFear").value == 'N'))
{document.getElementById("CriteriaA").value = 'NO';
alert("This patient does not meet the criteria for PTSD. Do not continue with interview.");
return false;
}
else
{document.getElementById("CriteriaA").value = 'YES';}
}
</script>
<script type="text/javascript" language="javascript">
function CriteriaBScore(){
var i = 0
if (document.getElementById("Recollections").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("Dreams").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("Recurrence").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("IntenseFeelings").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("PhysicalSx").value == 'Y'){i += 1;}
else {i += 0;}
if (i < 1)
{document.getElementById("CriteriaB").value = 'NO';
alert("This patient may not meet the criteria for PTSD. Consider alternate diagnosis.");
return false;
}
else
{document.getElementById("CriteriaB").value = 'YES';}
}
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<script type="text/javascript" language="javascript">
function CriteriaCScore(){
var i = 0
if (document.getElementById("AvoidThoughts").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("AvoidPlaces").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("Remembering").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("Interest").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("Detachment").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("RestrictedFeelings").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("Foreshortened").value == 'Y'){i += 1;}
else {i += 0;}
if (i < 3)
{document.getElementById("CriteriaC").value = 'NO';
alert("This patient may not meet the criteria for PTSD. Consider alternate diagnosis.");
return false;
}
else
{document.getElementById("CriteriaC").value = 'YES';}
}
</script>
<script type="text/javascript" language="javascript">
function CriteriaDScore(){
var i = 0
if (document.getElementById("Sleep").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("Irritability").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("Concentration").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("HyperVigilance").value == 'Y'){i += 1;}
else {i += 0;}
if (document.getElementById("Startle").value == 'Y'){i += 1;}
else {i += 0;}
if (i < 2)
{document.getElementById("CriteriaD").value = 'NO';
alert("This patient may not meet the criteria for PTSD. Consider alternate diagnosis.");
return false;
}
else
{document.getElementById("CriteriaD").value = 'YES';}
}
</script>
<script type="text/javascript" language="javascript">
function CriteriaEScore(){
if ((document.getElementById("Duration").value == 'N') || (document.getElementById("Duration").value == ''))
{document.getElementById("CriteriaE").value = 'NO';
alert("This patient may not meet the criteria for PTSD. Consider alternate diagnosis.");
return false;
}
else
{document.getElementById("CriteriaE").value = 'YES';}
}
</script>
<script type="text/javascript" language="javascript">
function CriteriaFScore(){
if ((document.getElementById("Distress").value == 'N') || (document.getElementById("Distress").value == ''))
{document.getElementById("CriteriaF").value = 'NO';
alert("This patient may not meet the criteria for PTSD. Consider alternate diagnosis.");
return false;
}
else
{document.getElementById("CriteriaF").value = 'YES';}
}
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</head>
<body onload="startUp();" onMouseDown="showButtons();">
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<div id="page1" style="position:relative; left:0px; top:0px; width:850px;" class="pagebreak">
<span style="position:absolute; left:0px; top:20px; width:850px; font-family:sans-serif; font-weight:bold; font-size:20px; text-align:center;">Clinician-Administered PTSD Scale</span>
<span style="position:absolute; left:80px; top:60px; font-family:sans-serif; font-weight:bold; font-size:12px;">Note: This tool must only be used by an experienced clinician as part of a properly structured psychiatric interview.</span>
<span id="Instructions" style="position:absolute; left:750px; top:60px; font-family:sans-serif; font-size:12px; font-weight:bold; color:blue; cursor:pointer; text-decoration:underline;" onclick="PopUp(this.id);">Instructions</span>
<span style="position:absolute; left:25px; top:87px; font-family:sans-serif; font-weight:bold; font-size:14px;">Patient name:</span>
<input name="PtName" id="PtName" type="text" class="noborder" style="position:absolute; left:121px; top:85px; width:200px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:left; background-color:transparent;" oscarDB=first_last_name>
<span style="position:absolute; left:325px; top:87px; font-family:sans-serif; font-weight:bold; font-size:14px;">Date of test:</span>
<input name="today" type="text" class="noborder" style="position:absolute; left:410px; top:85px; width:100px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:center; background-color:transparent;" oscarDB=today>
<span style="position:absolute; left:525px; top:87px; font-family:sans-serif; font-weight:bold; font-size:14px;">Administered by:</span>
<input name="AdministeredBy" type="text" class="noborder" style="position:absolute; left:650px; top:85px; width:200px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:left; background-color:transparent;" oscarDB=current_user>
<span style="position:absolute; left:25px; top:122px; font-family:sans-serif; font-weight:bold; font-size:14px;">Traumatic event:</span>
<textarea name="Trauma" type="text" style="position:absolute; left:140px; top:120px; width:181px; height:57px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:left; background-color:transparent;" value=""></textarea>
<span style="position:absolute; left:325px; top:122px; font-family:sans-serif; font-weight:bold; font-size:14px;">Date of event:</span>
<input name="DOE" type="text" class="noborder" style="position:absolute; left:420px; top:120px; width:100px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:center; background-color:transparent;" value="">
<span style="position:absolute; left:525px; top:122px; font-family:sans-serif; font-weight:bold; font-size:14px;">Interval:</span>
<input name="weeks" type="text" class="noborder" style="position:absolute; left:580px; top:120px; width:30px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:center; background-color:transparent;" value="">
<span style="position:absolute; left:610px; top:122px; font-family:sans-serif; font-weight:bold; font-size:14px;">weeks</span>
<input name="years" type="text" class="noborder" style="position:absolute; left:660px; top:120px; width:30px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:center; background-color:transparent;" value="">
<span style="position:absolute; left:690px; top:122px; font-family:sans-serif; font-weight:bold; font-size:14px;">years</span>
<!-- Drop Down -->
<textarea name="Past1" id="Past1" style="position:absolute; left:25px; top:181px; width:105px; height:20px; font-family:sans-serif; font-style:italic; font-size:16px; font-weight:bold; text-align:left; background-color:lightgreen;" class="noborder"></textarea>
<textarea name="Past2" id="Past2" style="position:absolute; left:165px; top:181px; width:100px; height:20px; font-family:sans-serif; font-style:italic; font-size:16px; font-weight:bold; text-align:center; background-color:lightgreen;" class="noborder"></textarea>
<select style="position:absolute; left:145px; top:205px; width:130px;" class="DoNotPrint">
<option onClick="document.FormName.Past1.value = ''; document.FormName.Past2.value = ''">please choose
<option onClick="document.FormName.Past1.value = 'In the past'; document.FormName.Past2.value = 'days'">In the past days
<option onClick="document.FormName.Past1.value = 'In the past'; document.FormName.Past2.value = 'weeks'">In the past weeks
<option onClick="document.FormName.Past1.value = 'In the past'; document.FormName.Past2.value = 'months'">In the past months
<option onClick="document.FormName.Past1.value = 'Since your'; document.FormName.Past2.value = 'last visit'">Since last visit
</select>
<input name="PastNumber" type="text" class="noborder" style="position:absolute; left:130px; top:182px; width:35px; height:20px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:16px; text-align:center; background-color:lightgreen;" value="">
<span style="position:absolute; left:265px; top:182px; height:20px; font-family:sans-serif; font-style:italic; font-weight:bold; font-size:16px; background-color:lightgreen;"> have you had or experienced any of the following?</span>
<span class="DoNotPrint" style="position:absolute; left:285px; top:208px; font-family:sans-serif; font-style:italic; font-weight:normal; font-size:14px; background-color:transparent; color:#6495ED;">Please indicate the time frame for which the answers below apply.</span>
<!-- Group A -->
<span style="position:absolute; left:25px; top:227px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:14px;">Criteria Group A (BOTH 1 & 2 required):</span>
<span style="position:absolute; left:25px; top:247px; font-family:sans-serif; font-weight:normal; font-size:14px;">(1)   Life threat?</span>
<!-- Drop Down -->
<textarea name="Life" id="Life" style="position:absolute; left:180px; top:244px; width:25px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:200px; top:244px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Life.value = ''">
<option onClick="document.FormName.Life.value = 'N'">N
<option onClick="document.FormName.Life.value = 'Y'">Y
</select>
<span style="position:absolute; left:285px; top:247px; font-family:sans-serif; font-weight:normal; font-size:14px;">[self</span>
<input name="LifeThreatSelf" id="LifeThreatSelf" type="text" style="position:absolute; left:315px; top:247px; width:14px; height:14px; border:1px solid #000000; font-weight:bold; font-size:14px; text-align:center; background-color:transparent;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);" onkeypress="javascript:return displayKeyCode(event,this.id);">
<span style="position:absolute; left:340px; top:247px; font-family:sans-serif; font-weight:normal; font-size:14px;">other(s)</span>
<input name="LifeThreatOther" id="LifeThreatOther" type="text" style="position:absolute; left:393px; top:247px; width:14px; height:14px; border:1px solid #000000; font-weight:bold; font-size:14px; text-align:center; background-color:transparent;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);" onkeypress="javascript:return displayKeyCode(event,this.id);">
<span style="position:absolute; left:410px; top:247px; font-family:sans-serif; font-weight:normal; font-size:14px;">]</span>
<span style="position:absolute; left:435px; top:247px; font-family:sans-serif; font-style:italic; font-weight:bold; font-size:14px;">and/or</span>
<span style="position:absolute; left:53px; top:264px; font-family:sans-serif; font-weight:normal; font-size:14px;">Serious injury?</span>
<!-- Drop Down -->
<textarea name="SeriousInj" id="SeriousInj" style="position:absolute; left:180px; top:261px; width:25px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:200px; top:261px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.SeriousInj.value = ''">
<option onClick="document.FormName.SeriousInj.value = 'N'">N
<option onClick="document.FormName.SeriousInj.value = 'Y'">Y
</select>
<span style="position:absolute; left:285px; top:264px; font-family:sans-serif; font-weight:normal; font-size:14px;">[self</span>
<input name="SeriousInjSelf" id="SeriousInjSelf" type="text" style="position:absolute; left:315px; top:264px; width:14px; height:14px; border:1px solid #000000; font-weight:bold; font-size:14px; text-align:center; background-color:transparent;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);" onkeypress="javascript:return displayKeyCode(event,this.id);">
<span style="position:absolute; left:340px; top:264px; font-family:sans-serif; font-weight:normal; font-size:14px;">other(s)</span>
<input name="SeriousInjOther" id="SeriousInjOther" type="text" style="position:absolute; left:393px; top:264px; width:14px; height:14px; border:1px solid #000000; font-weight:bold; font-size:14px; text-align:center; background-color:transparent;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);" onkeypress="javascript:return displayKeyCode(event,this.id);">
<span style="position:absolute; left:410px; top:264px; font-family:sans-serif; font-weight:normal; font-size:14px;">]</span>
<span style="position:absolute; left:435px; top:264px; font-family:sans-serif; font-style:italic; font-weight:bold; font-size:14px;">and/or</span>
<span style="position:absolute; left:53px; top:281px; font-family:sans-serif; font-weight:normal; font-size:14px;">Integrity threat?</span>
<!-- Drop Down -->
<textarea name="IntegrityThreat" id="IntegrityThreat" style="position:absolute; left:180px; top:278px; width:25px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:200px; top:278px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.IntegrityThreat.value = ''">
<option onClick="document.FormName.IntegrityThreat.value = 'N'">N
<option onClick="document.FormName.IntegrityThreat.value = 'Y'">Y
</select>
<span style="position:absolute; left:285px; top:281px; font-family:sans-serif; font-weight:normal; font-size:14px;">[self</span>
<input name="IntegrityThreatSelf" id="IntegrityThreatSelf" type="text" style="position:absolute; left:315px; top:281px; width:14px; height:14px; border:1px solid #000000; font-weight:bold; font-size:14px; text-align:center; background-color:transparent;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);" onkeypress="javascript:return displayKeyCode(event,this.id);">
<span style="position:absolute; left:340px; top:281px; font-family:sans-serif; font-weight:normal; font-size:14px;">other(s)</span>
<input name="IntegrityThreatOther" id="IntegrityThreatOther" type="text" style="position:absolute; left:393px; top:281px; width:14px; height:14px; border:1px solid #000000; font-weight:bold; font-size:14px; text-align:center; background-color:transparent;" onkeypress="javascript:return displayKeyCode(event,this.id);" onmousedown="changeValue(this.id);" onkeypress="javascript:return displayKeyCode(event,this.id);">
<span style="position:absolute; left:410px; top:281px; font-family:sans-serif; font-weight:normal; font-size:14px;">]</span>
<span style="position:absolute; left:435px; top:281px; font-family:sans-serif; font-style:italic; font-weight:bold; font-size:14px;">and/or</span>
<textarea name="CriteriaAComment" style="position:absolute; left:525px; top:244px; width:325px; height:60px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:left; background-color:transparent;" value="">Comment: </textarea>
<span style="position:absolute; left:25px; top:311px; font-family:sans-serif; font-weight:normal; font-size:14px;">(2)   Intense Fear/Helplessness/Horror?</span>
<!-- Drop Down -->
<textarea name="IntenseFear" id="IntenseFear" style="position:absolute; left:285px; top:308px; width:25px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:305px; top:308px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.IntenseFear.value = ''">
<option onClick="document.FormName.IntenseFear.value = 'N'">N
<option onClick="document.FormName.IntenseFear.value = 'Y'">Y
</select>
<input class="NoBorder" type="button" name="CriteriaA_Score" style="position:absolute; left:525px; top:308px; width:100px; font-size:12px; background-color:yellow;" onclick="CriteriaAScore();" value="Criteria A met?">
<input name="CriteriaA" id="CriteriaA" type="text" class="noborder" style="position:absolute; left:650px; top:308px; width:50px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:16px; text-align:center; background-color:transparent;">
<!-- Group B -->
<span style="position:absolute; left:25px; top:341px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:14px;">Criteria Group B (Re-experiencing of event; ONE required):</span>
<span style="position:absolute; left:25px; top:361px; font-family:sans-serif; font-weight:normal; font-size:14px;">(1)   Recurrent, intrusive, distressing RECOLLECTIONS of the event:</span>
<textarea name="Recollections" id="Recollections" style="position:absolute; left:525px; top:358px; width:25px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:358px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Recollections.value = ''">
<option onClick="document.FormName.Recollections.value = 'N'">N
<option onClick="document.FormName.Recollections.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:378px; font-family:sans-serif; font-weight:normal; font-size:14px;">(2)   Recurrent, distressing DREAMS of the event:</span>
<textarea name="Dreams" id="Dreams" style="position:absolute; left:525px; top:375px; width:25px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:375px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Dreams.value = ''">
<option onClick="document.FormName.Dreams.value = 'N'">N
<option onClick="document.FormName.Dreams.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:395px; font-family:sans-serif; font-weight:normal; font-size:14px;">(3)   A sense that the event(s) is/are happening to you all over again:*</span>
<textarea name="Recurrence" id="Recurrence" style="position:absolute; left:525px; top:392px; width:25px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:392px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Recurrence.value = ''">
<option onClick="document.FormName.Recurrence.value = 'N'">N
<option onClick="document.FormName.Recurrence.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:412px; font-family:sans-serif; font-weight:normal; font-size:14px;">(4)   Intense and distressing feeling or emotions in response to cues:**</span>
<textarea name="IntenseFeelings" id="IntenseFeelings" style="position:absolute; left:525px; top:409px; width:25px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:409px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.IntenseFeelings.value = ''">
<option onClick="document.FormName.IntenseFeelings.value = 'N'">N
<option onClick="document.FormName.IntenseFeelings.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:429px; font-family:sans-serif; font-weight:normal; font-size:14px;">(5)   Physical symptoms, e.g. shaking, nausea, etc., in response to cues:**</span>
<textarea name="PhysicalSx" id="PhysicalSx" style="position:absolute; left:525px; top:426px; width:25px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:426px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.PhysicalSx.value = ''">
<option onClick="document.FormName.PhysicalSx.value = 'N'">N
<option onClick="document.FormName.PhysicalSx.value = 'Y'">Y
</select>
<textarea name="CriteriaBComment" style="position:absolute; left:585px; top:358px; width:265px; height:83px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:left; background-color:transparent;" value="">Comment: </textarea>
<input class="NoBorder" type="button" name="CriteriaB_Score" style="position:absolute; left:525px; top:446px; width:100px; font-size:12px; background-color:yellow;" onclick="CriteriaBScore();" value="Criteria B met?">
<input name="CriteriaB" id="CriteriaB" type="text" class="noborder" style="position:absolute; left:650px; top:444px; width:50px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:16px; text-align:center; background-color:transparent;">
<!-- Group C -->
<span style="position:absolute; left:25px; top:477px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:14px;">Criteria Group C (Avoidance of stimuli associated with traumatic event; THREE required):</span>
<span style="position:absolute; left:25px; top:499px; font-family:sans-serif; font-weight:normal; font-size:14px;">(1)   Efforts to avoid thoughts, feelings, conversations about the traumatic event:</span>
<textarea name="AvoidThoughts" id="AvoidThoughts" style="position:absolute; left:525px; top:496px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:496px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.AvoidThoughts.value = ''">
<option onClick="document.FormName.AvoidThoughts.value = 'N'">N
<option onClick="document.FormName.AvoidThoughts.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:516px; font-family:sans-serif; font-weight:normal; font-size:14px;">(2)   Efforts to avoid places, activities, or situations that remind you of the event:</span>
<textarea name="AvoidPlaces" id="AvoidPlaces" style="position:absolute; left:525px; top:513px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:513px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.AvoidPlaces.value = ''">
<option onClick="document.FormName.AvoidPlaces.value = 'N'">N
<option onClick="document.FormName.AvoidPlaces.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:533px; font-family:sans-serif; font-weight:normal; font-size:14px;">(3)   Difficulty </span>
<span style="position:absolute; left:110px; top:533px; font-family:sans-serif; font-weight:normal; font-style:italic; font-size:14px; background-color:pink;">remembering </span>
<span style="position:absolute; left:197px; top:533px; font-family:sans-serif; font-weight:normal; font-size:14px;">some important part of the traumatic event: </span>
<textarea name="Remembering" id="Remembering" style="position:absolute; left:525px; top:530px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:530px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Remembering.value = ''">
<option onClick="document.FormName.Remembering.value = 'N'">N
<option onClick="document.FormName.Remembering.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:550px; font-family:sans-serif; font-weight:normal; font-size:14px;">(4)   Loss of interest in engaging in previously enjoyed activities:</span>
<textarea name="Interest" id="Interest" style="position:absolute; left:525px; top:547px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:547px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Interest.value = ''">
<option onClick="document.FormName.Interest.value = 'N'">N
<option onClick="document.FormName.Interest.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:567px; font-family:sans-serif; font-weight:normal; font-size:14px;">(5)   Feelings of</span>
<span style="position:absolute; left:127px; top:567px; font-family:sans-serif; font-weight:normal; font-style:italic; font-size:14px; background-color:pink;">detachment</span>
<span style="position:absolute; left:205px; top:567px; font-family:sans-serif; font-weight:normal; font-size:14px;">from others: </span>
<textarea name="Detachment" id="Detachment" style="position:absolute; left:525px; top:564px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:564px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Detachment.value = ''">
<option onClick="document.FormName.Detachment.value = 'N'">N
<option onClick="document.FormName.Detachment.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:584px; font-family:sans-serif; font-weight:normal; font-size:14px;">(6)   Restricted range of feelings or emotions:</span>
<textarea name="RestrictedFeelings" id="RestrictedFeelings" style="position:absolute; left:525px; top:581px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:581px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.RestrictedFeelings.value = ''">
<option onClick="document.FormName.RestrictedFeelings.value = 'N'">N
<option onClick="document.FormName.RestrictedFeelings.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:601px; font-family:sans-serif; font-weight:normal; font-size:14px;">(7)   Sense of foreshortened future:</span>
<textarea name="Foreshortened" id="Foreshortened" style="position:absolute; left:525px; top:598px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:598px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Foreshortened.value = ''">
<option onClick="document.FormName.Foreshortened.value = 'N'">N
<option onClick="document.FormName.Foreshortened.value = 'Y'">Y
</select>
<textarea name="CriteriaCComment" style="position:absolute; left:585px; top:496px; width:265px; height:118px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:left; background-color:transparent;" value="">Comment: </textarea>
<input class="NoBorder" type="button" name="CriteriaC_Score" style="position:absolute; left:525px; top:618px; width:100px; font-size:12px; background-color:yellow;" onclick="CriteriaCScore();" value="Criteria C met?">
<input name="CriteriaC" id="CriteriaC" type="text" class="noborder" style="position:absolute; left:650px; top:618px; width:50px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:16px; text-align:center; background-color:transparent;">
<!-- Group D -->
<span style="position:absolute; left:25px; top:651px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:14px;">Criteria Group D (Hyper-arousal not present prior to event; TWO required):</span>
<span style="position:absolute; left:25px; top:671px; font-family:sans-serif; font-weight:normal; font-size:14px;">(1)   Difficulty falling or staying asleep:</span>
<textarea name="Sleep" id="Sleep" style="position:absolute; left:525px; top:668px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:668px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Sleep.value = ''">
<option onClick="document.FormName.Sleep.value = 'N'">N
<option onClick="document.FormName.Sleep.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:688px; font-family:sans-serif; font-weight:normal; font-size:14px;">(2)   Irritability - quick to anger:</span>
<textarea name="Irritability" id="Irritability" style="position:absolute; left:525px; top:685px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:685px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Irritability.value = ''">
<option onClick="document.FormName.Irritability.value = 'N'">N
<option onClick="document.FormName.Irritability.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:705px; font-family:sans-serif; font-weight:normal; font-size:14px;">(3)   Difficulty concentrating:</span>
<textarea name="Concentration" id="Concentration" style="position:absolute; left:525px; top:702px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:702px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Concentration.value = ''">
<option onClick="document.FormName.Concentration.value = 'N'">N
<option onClick="document.FormName.Concentration.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:722px; font-family:sans-serif; font-weight:normal; font-size:14px;">(4)   Hyper-vigilance - on edge:</span>
<textarea name="HyperVigilance" id="HyperVigilance" style="position:absolute; left:525px; top:719px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:719px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.HyperVigilance.value = ''">
<option onClick="document.FormName.HyperVigilance.value = 'N'">N
<option onClick="document.FormName.HyperVigilance.value = 'Y'">Y
</select>
<span style="position:absolute; left:25px; top:739px; font-family:sans-serif; font-weight:normal; font-size:14px;">(5)   Exaggerated startle response:***</span>
<textarea name="Startle" id="Startle" style="position:absolute; left:525px; top:736px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:736px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Startle.value = ''">
<option onClick="document.FormName.Startle.value = 'N'">N
<option onClick="document.FormName.Startle.value = 'Y'">Y
</select>
<textarea name="CriteriaDComment" style="position:absolute; left:585px; top:668px; width:265px; height:83px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:left; background-color:transparent;" value="">Comment: </textarea>
<input class="NoBorder" type="button" name="CriteriaD_Score" style="position:absolute; left:525px; top:756px; width:100px; font-size:12px; background-color:yellow;" onclick="CriteriaDScore();" value="Criteria D met?">
<input name="CriteriaD" id="CriteriaD" type="text" class="noborder" style="position:absolute; left:650px; top:756px; width:50px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:16px; text-align:center; background-color:transparent;">
<!-- Group E -->
<span style="position:absolute; left:25px; top:789px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:14px;">Criteria Group E (Persistence of symptoms):</span>
<span style="position:absolute; left:25px; top:809px; font-family:sans-serif; font-weight:normal; font-size:14px;">Duration of symptoms endorsed in B, C, and D is greater than 1 month.</span>
<textarea name="Duration" id="Duration" style="position:absolute; left:525px; top:806px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:806px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Duration.value = ''">
<option onClick="document.FormName.Duration.value = 'N'">N
<option onClick="document.FormName.Duration.value = 'Y'">Y
</select>
<input class="NoBorder" type="button" name="CriteriaE_Score" style="position:absolute; left:525px; top:826px; width:100px; font-size:12px; background-color:yellow;" onclick="CriteriaEScore();" value="Criteria E met?">
<input name="CriteriaE" id="CriteriaE" type="text" class="noborder" style="position:absolute; left:650px; top:826px; width:50px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:16px; text-align:center; background-color:transparent;">
<!-- Group F -->
<span style="position:absolute; left:25px; top:859px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:14px;">Criteria Group F:</span>
<span style="position:absolute; left:25px; top:879px; font-family:sans-serif; font-weight:normal; font-size:14px;">The symptoms cause significant distress and impairment of function.</span>
<textarea name="Distress" id="Distress" style="position:absolute; left:525px; top:876px; width:50px; height:16px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:545px; top:876px; width:40px;" class="DoNotPrint">
<option onClick="document.FormName.Distress.value = ''">
<option onClick="document.FormName.Distress.value = 'N'">N
<option onClick="document.FormName.Distress.value = 'Y'">Y
</select>
<input class="NoBorder" type="button" name="CriteriaF_Score" style="position:absolute; left:525px; top:896px; width:100px; font-size:12px; background-color:yellow;" onclick="CriteriaFScore();" value="Criteria F met?">
<input name="CriteriaF" id="CriteriaF" type="text" class="noborder" style="position:absolute; left:650px; top:896px; width:50px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:16px; text-align:center; background-color:transparent;">
<!-- Specifiers -->
<span style="position:absolute; left:25px; top:929px; font-family:sans-serif; font-style:normal; font-weight:bold; font-size:14px;">Specifiers:</span>
<span style="position:absolute; left:25px; top:949px; font-family:sans-serif; font-weight:normal; font-size:14px;">The symptoms have been present for:</span>
<textarea name="Specifier" id="Specifier" style="position:absolute; left:525px; top:945px; width:100px; height:22px; font-family:Arial; font-size:16px; font-weight:bold;" class="noborder"></textarea>
<select style="position:absolute; left:265px; top:949px; width:180px; font-family:sans-serif; font-size:14px;" class="NoBorder">
<option onClick="document.FormName.Specifier.value = ''">
<option onClick="document.FormName.Specifier.value = 'Acute'">less than 3 months
<option onClick="document.FormName.Specifier.value = 'Chronic'">longer than 3 months
</select>
<span style="position:absolute; left:25px; top:979px; font-family:sans-serif; font-weight:normal; font-size:14px;">* Includes "flash backs", hallucinations, and similar episodes.</span>
<span style="position:absolute; left:25px; top:996px; font-family:sans-serif; font-weight:normal; font-size:14px;">** "Cues" are internal or external symbols or situations that resemble some aspect of the traumatic event.</span>
<span style="position:absolute; left:25px; top:1013px; font-family:sans-serif; font-weight:normal; font-size:14px;">*** e.g. door slamming, car back-firing, etc.</span>
<textarea name="Comments" type="text" style="position:absolute; left:25px; top:1050px; width:825px; height:57px; font-family:sans-serif; font-style:normal; font-weight:normal; font-size:16px; text-align:left; background-color:transparent;" value="">Additional Comments: </textarea>
<!-- ------------------------End form inputs----------------------------------- -->
Result - Copy and paste this output:
Sandbox Metrics: Structured Data Index 0, 5864 boilerplate words
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