The rater scored this item incorrectly. The intensity rating of Pronounced is incorrect. It should have been rated Extreme. The severity score is also incorrect. It should be: 3 Severe/markedly elevated.

Rationale: Brian identified a number of reminders that cause him to have physiological responses; many of these were the same as the reminders he mentioned in B4. Notice that although he initially started talking about having these responses in crowds, the interviewer was able to clarify that these were not responses due to reminders of the trauma, but rather indicative of hypervigilance. By clarifying and redirecting, the interviewer avoided double coding. Brian reported reactions that were “extreme”; he indicated that when confronted with reminders, he noticed his heart racing, breathing change, sweating, and feeling tense and shaky, and stated that it takes him a couple of hours to return to baseline. Like before, because the frequency is in the “pronounced range (3x/week), Brian’s severity score is a “3: Severe/markedly elevated.” The correct choices are shown to the right.