Click on the picture (on right) and print the assessment instrument.

For each question on the PQ-B,  indicate whether you have had the thoughts, feelings and/or experiences described in the past month by checking “yes” or “no” for each item. Do not include experiences that occur only while under the influence of alcohol, drugs or medications that were not prescribed to you.

If you answer “YES” to an item, also indicate how distressing that experience has been for you.



Items answered “no” are scored as zero.

For each item marked “yes,” scores are determined based on the participant’s level of agreement with the statement, “When this happens, I feel frightened, concerned, or it causes problems for me,” on a Likert-type scale ranging from “strongly disagree” (scored as one) to “strongly agree” (scored as five).

Respondents with a total score of 6 or more show a higher risk and are encouraged to follow up with a more detailed face to face evaluation with a mental health professional.

WARNING: Self report screening tools (such as the PQ-B) are tools used to provide preliminary information to help an individual make decisions regarding the need to seek further assessment and follow up services.  Screening tools are not intended to be used alone to make or confirm a diagnosis.  Scores lower than a 6 might need follow up if symptoms or level of distress changes at any time.  

For questions regarding your score, or other concerns you may have, please contact Craig Limb, LCSW (PREP Team Supervisor) at:
(801) 373-1213
or use our Contact Form to send a message.