Basic Objectives of Psychological First Aid

Enhance immediate and ongoing safety, and provide physical and emotional
comfort. Calm and orient emotionally overwhelmed or distraught individuals.

DR. DEEPTI MANKAD

  SPECIFIC CHECKLIST 

FATIGUE

The Warning Signs Are: If you become aware of these signs, you should
• Inability to stay awake take the following steps:

• Clumsiness • Use your maximum allowance of sleep, rest and

leisure time
• Headaches and giddiness
• Inform your supervisor if you think fatigue may be
• Loss of appetite impairing your performance

• Insomnia • Where possible, rotate your tasks to mix heavy and

lighter duties
• Moodiness and needless
• Exercise daily
worrying
• Eat as healthily as possible, limit smoking, caffeine
• Poor judgement of distance,
and alcohol consumption
speed, time and risk

• Slow responses

• Difficulty concentrating

STRESS

The signs of job stress vary from person to person, depending on the particular
situation, how long the seafarer has been subjected to the stressors, and the
intensity of the stress itself.

Typical symptoms of job stress can Possible solutions for job related stress are:
be:
• to identify stressors in life, such as work, or family
• Insomnia
• to get adequate sleep and rest to maintain energy
• loss of mental levels
concentration • to eat a healthy, balanced diet with a limited
intake of caffeine and alcohol
• anxiety
• to develop alternative activities such as a relaxing
• substance abuse
hobby
• extreme anger and • to take support and advice from friends and family
frustration
• to consider meditation or gym, aerobics or sports
• family conflict to switch focus, and to reorganize priorities

• physical illnesses such as heart disease, migraine,

• headaches, stomach problems, and back problems.

 Stress & Coping Self-Test
Instructions: Answer all 18 of the following questions about how you feel and how things have
been going with you during the past month. Mark the response that best applies to you.

QUESTION A B C D E F
How have you been feeling n5 n4 n3 n2 n1 n0
in general? In an excellent In a very good In a good mood My mood has been In a poor frame of In a very poor frame
frame of mind mood mostly up and down mind mostly of mind
Have you been bothered by n5 n4 n3 n2 n1 n0
nervousness? Not at all A little Some – enough Yes – quite a bit Yes – very much so Extremely so – to
to bother me the point where I
could not work or
take care of things
Have you been in firm n5 n4 n3 n2 n1 n0
control of your behavior, Yes, definitely so Yes, for the most Generally so Not too well No, and I am No, and I am very
thoughts, emotions, and part somewhat troubled by that
feelings? troubled by that
Have you been feeling n5 n4 n3 n2 n1 n0
so sad, discouraged, or Not at all A little Some – enough Yes – quite a bit Yes – very much so Extremely so – to
hopeless, or had so many to bother me the point that I have
problems that you wondered just about given up
if anything was worthwhile?
Have you been feeling that n5 n4 n3 n2 n1 n0
you were under any strain, Not at all A little About the same Yes – more than Yes – quite a bit of Yes – almost more
stress, or pressure? amount as usual usual pressure than I could bear
How happy or satisfied have n5 n4 n3 n2 n1 n0
you been with your personal Extremely happy Very happy Fairly happy Somewhat satisfied Somewhat Very dissatisfied
life? dissatisfied
Have you had any reason to n5 n4 n3 n2 n1 n0
wonder if you were losing Not at all Only a little Some – but not Some, and I have Some, and I am Yes, a lot, and I am
your mind or memory, or enough to be been a little quite concerned very concerned
losing control over the way concerned concerned
you act, talk, think, or feel?
Have you been anxious, n5 n4 n3 n2 n1 n0
worried, or upset? Not at all A little Some – enough Yes – quite a bit Yes – very much so Yes – extremely so,
to bother me to the point of being
sick or almost sick
How often have you n5 n4 n3 n2 n1 n0
awakened refreshed and Every day Almost every Fairly often Less than half the Rarely None of the time
rested? day time
Have you been bothered by n5 n4 n3 n2 n1 n0
an illness, bodily disorder, Not at all A little Some of the Yes – a good bit of Yes – most of the Yes – all of the time
pain, or fear about your health? time the time time
Has your daily life been full of n5 n4 n3 n2 n1 n0
things that were interesting Yes – all of the Yes – most of the Yes – a good bit Some of the time A little Not at all
to you? time time of the time
Have you been feeling n5 n4 n3 n2 n1 n0
down-hearted and blue? Not at all A little Some of the Yes – a good bit of Yes – most of the Yes – all of the time
time the time time
Have you been feeling n5 n4 n3 n2 n1 n0
emotionally stable and sure Yes – all of the Yes – most of the Yes – a good bit Some of the time A little Not at all
of yourself? time time of the time
Have you been feeling n5 n4 n3 n2 n1 n0
tired, worn out, used-up, or Not at all A little Some of the Yes – a good bit of Yes – most of the Yes – all of the time
exhausted? time the time time

ADD UP THE NUMBERS NEXT TO EACH CHECKED BOX.


QUESTION
How concerned or worried have
you been about your health?
How relaxed or tense have you
been?
How much energy, pep, or
vitality have you had?
How depressed or cheerful have
you been?
Check the number on the scale (from 0-10) that seems closest to how
you have generally been feeling during the past month.
10
n n 9 n 8 n 7 n 6 n 5 n 4 n 3 n 2 n 1 n0
Not concerned at all Very concerned
10
n n 9 n 8 n 7 n 6 n 5 n 4 n 3 n 2 n 1 n0
Very relaxed Very tense
n 10 n 9 n 8 n 7 n 6 n 5 n 4 n 3 n 2 n 1 n0
Very energetic, dynamic No energy at all, listless
10
n n 9 n 8 n 7 n 6 n 5 n 4 n 3 n 2 n 1 n0
Very cheerful Very depressed

Scoring
Your score for each question is the number beside each check box. Add ADD UP THE NUMBERS NEXT TO EACH CHECKED BOX.
the scores for all questions to get a total score (use summary grid below).
Your total score should be between 0 and 110. WRITE IN YOUR TOTAL FROM PAGE 1.
What Your Score Means
ADD THESE TOGETHER FOR YOUR TOTAL SCORE
Coping Score Stress/Coping Description (Your total score should be between 0 and 110.)

76-110 Coping well. You are in the The higher your score the better you are coping with stress in your life.
“Positive Well Being” zone. Scores of 76 or above indicate that you are coping well. A score of 71-75 is
71-75 Marginal “marginal” and scores of 70 or less indicate you are having trouble coping
and need to improve your coping skills. Read Improving Coping Skills below.
56-70 Not coping very well. Get additional help if needed from your health coach, a mental health
You are in the “Stress” zone. counselor, or your doctor.
0-55 Not coping well at all.
You are in the “Distress” zone. Source: National Center for Health Statistics. NHANES Study.

Improving Coping Skills

Stress and Coping How to Cope Better with Stress
Some stress is a normal part of daily • Reduce your stress load. Learn to say “no” if already overloaded.
life. If it becomes excessive, however, • Develop a good support system – people you can talk with and get
and exceeds your ability to cope, it help from when needed.
can result in feelings of:
• Break the stress cycle with relaxation. Do something you enjoy
• Tension • Irritability every day.
• Anxiety, • Difficulty sleeping • Get regular, moderate exercise, such as walking or biking in park or by
Unrelieved stress can adversely affect your health. Take the Stress and a scenic lake.
Coping Self-Test to help you become aware of how you are currently • Do stretching exercises and practice deep breathing to relax the body.
coping with stress in your life. Then see the suggestions listed below for
• Learn to forgive and forget. Resentment hurts you the most.
help in making improvement.
• Get help from your supervisor at work to deal with work stressors.
Sources of Stress • Don’t be hard on yourself. Realize that everyone makes mistakes.
Stress that results in feelings of tension and anxiety can arise from many • Take care of yourself. Get 7-8 hours of sleep daily. Eat regular meals.
sources. Here are a few: Limit caffeine and alcohol.
• Work stressors (long hours, difficult people to work with, deadlines, etc.). • Live one day at a time. Don’t worry excessively about future problems
• Home stressors (conflict with children or spouse, home demands, etc.) which likely won’t happen anyway. Focus on what you can do today.
• Finances (debt, spending conflict, job loss, difficult economy, etc.) • Be positive and optimistic in your thinking. Humans tend to
• Feeling a loss of control over one’s life experience in life what they expect.
• Feeling sad and depressed • Join an encouraging faith or support group. Caring friends can help
you cope.
• Major life events (divorce, moving, new job, loss of a loved one, a
tragedy, etc.) • Get professional help when needed. Talk to a financial counselor, a
dietitian, a mental health counselor, or your doctor as needed.
• Health problems
A person who takes control of his or her life and approaches stressful life
Whatever the cause, when the stress load becomes too great for you to
events as opportunities to learn or grow is more resistant to stress and lives
cope with, your mental and physical health decline. See the suggestions
a healthier, more fulfilled life.
in the next column for ways of improving your coping ability and keeping
stress loads reasonable.
  SPECIFIC CHECKLIST 

ANXIETY

Common anxiety signs and symptoms include:

Feeling nervous, restless or tense

Having a sense of impending danger, panic or doom

Having an increased heart rate

Breathing rapidly (hyperventilation)

Sweating

Trembling

Feeling weak or tired

Trouble concentrating or thinking about anything other than the present

worry

Having trouble sleeping

Experiencing gastrointestinal (GI) problems

Having difficulty controlling worry

Having the urge to avoid things that trigger anxiety

1
 Anxiety
NAME:
SEX:
AGE: Self-Test
Circle any one score for each column.

After completing take a total of all the points which you have circled.

Total Score =

What your total score means

Your total score is a guide to how severe your anxiety disorder may be:
0 to 4 = mild anxiety
5 to 9 = moderate anxiety
10 to 14 = moderately severe anxiety
15 to 21 = severe anxiety
If your score is 10 or higher, or if you feel that anxiety is affecting your daily life, call your
doctor.
DEPRESSION

▪ Fatigue or loss of energy

▪ Thoughts of death or suicide, including suicide attempts

▪ Feeling guilty, hopeless or worthless

▪ Difficulty concentrating, remembering or making decisions

▪ Persistent sad, anxious or empty mood

▪ Sleeping too much or too little; odd time of waking

▪ Reduced or increased appetite which results in weight gain or loss.

▪ Irritability or restlessness

BIPOLAR

Common signs and symptoms of MANIA include:

Feeling unusually “high” and optimistic OR extremely irritable

Unrealistic, grandiose beliefs about one’s abilities or powers

Sleeping very little, but feeling extremely energetic

Talking so rapidly that others can’t keep up

Racing thoughts; jumping quickly from one idea to the next

Highly distractible, unable to concentrate

Impaired judgment and impulsiveness

Acting recklessly without thinking about the consequences

Delusions and hallucinations (in severe cases)

Common symptoms of bipolar DEPRESSION include:

Feeling hopeless, sad, or empty

Irritability

Inability to experience pleasure

Fatigue or loss of energy

 Physical and mental sluggishness

Appetite or weight changes

Sleep problems

Concentration and memory problems

Feelings of worthlessness or guilt

Thoughts of death or suicide

POST TRAUMATIC STRESS SYNDROME [PTSD]

Symptoms of changes in physical and emotional reactions (also called arousal

symptoms) may include:

Being easily startled or frightened

Always being on guard for danger

Self-destructive behavior, such as drinking too much or driving too fast

Trouble sleeping

Trouble concentrating

Irritability, angry outbursts or aggressive behavior

Overwhelming guilt or shame

Symptoms of negative changes in thinking and mood may include:

Negative thoughts about yourself, other people or the world

Hopelessness about the future

Memory problems, including not remembering important aspects of the

traumatic event

Difficulty maintaining close relationships

Feeling detached from family and friends

Lack of interest in activities you once enjoyed

Difficulty experiencing positive emotions

Feeling emotionally numb

 PTSD CheckList – Civilian Version (PCL-C)

Client’s Name: __________________________________________

Instruction to patient: Below is a list of problems and complaints that veterans sometimes have in response to stressful life
experiences. Please read each one carefully, put an “X” in the box to indicate how much you have been bothered by that
problem in the last month.

Not at all A little bit Moderately Quite a bit Extremely

No. Response
(1) (2) (3) (4) (5)
Repeated, disturbing memories, thoughts, or images
1.
of a stressful experience from the past?
Repeated, disturbing dreams of a stressful
2.
experience from the past?
Suddenly acting or feeling as if a stressful experience
3.
were happening again (as if you were reliving it)?
Feeling very upset when something reminded you of
4.
a stressful experience from the past?
Having physical reactions (e.g., heart pounding,
trouble breathing, or sweating) when something
5.
reminded you of a stressful experience from the
past?
Avoid thinking about or talking about a stressful
6. experience from the past or avoid having feelings
related to it?
Avoid activities or situations because they remind
7.
you of a stressful experience from the past?
Trouble remembering important parts of a stressful
8.
experience from the past?
9. Loss of interest in things that you used to enjoy?
10. Feeling distant or cut off from other people?
Feeling emotionally numb or being unable to have
11.
loving feelings for those close to you?
12. Feeling as if your future will somehow be cut short?
13. Trouble falling or staying asleep?
14. Feeling irritable or having angry outbursts?
15. Having difficulty concentrating?
16. Being “super alert” or watchful on guard?
17. Feeling jumpy or easily startled?
Behaviour Feelings

Thoughts Physical