POSTTRAUMATIC STRESS DISORDER (PTSD) 257 B. The client reported beginning to be in touch with his/her feelings again. C. The client is able to experience the full range of emotions. 14. Pessimistic/Fatalistic (13) A. Since the traumatic event occurred, the client has had a pessimistic and fatalistic attitude regarding the future. B. The client is beginning to experience a somewhat hopeful attitude regarding the future. C. The client's pessimistic, fatalistic att itude regarding the future has terminated, and he/she has begun to make plans and talk about the future with a more hopeful attitude. 15. Sleep Disturbance (14) A. Since the traumatic event occurred, the client has experienced a desire to sleep much more than normal. B. Since the traumatic event occurred, the client has found it very difficult to initiate and maintain sleep. C. Since the traumatic event occurred, the client has had a fear of sleeping. D. The client's sleep disturbance has terminated, an d he/she has returned to a normal sleep pattern. 16. Irritability (15) A. The client described a pattern of irritability that was not present before the traumatic event occurred. B. The client reported incidents of becoming angry and losing his/her tempe r easily, resulting in explosive outbursts. C. The client's irritability has diminished somewhat, and the intensity of the explosive outbursts has lessened. D. The client reported no recent incidents of explosive, angry outbursts. 17. Lack of Concentrati on (16) A. The client described a pattern of lack of concentration that began with the exposure to the traumatic event. B. The client reported that he/she is now able to focus more clearly on cognitive processing. C. The client's ability to concentrate has returned to normal levels. 18. Hypervigilance (17) A. The client described a pattern of hypervigilance. B. The client's hypervigilant pattern has diminished. C. The client reported no longer experiencing hypervigilance. 19. Exaggerated Startle Respo nse (18) A. The client described having experienced an exaggerated startle response. B. The client's exaggerated startle response has diminished. C. The client no longer experiences an exaggerated startle response. 20. Depression (19) A. The client des cribed experiencing sad affect, lack of energy, social withdrawal, and guilt feelings as part of a depressive reaction. 