Expression questions were specifically selected to locate youth who are likely suffering from PTSD and/or depression based on criteria from the DSM-5, the Centers for Disease Control 2016 (CDC), and by the National Child Traumatic Stress Network (NCTSN) in 2017. Additionally, several questions were borrowed from two validated instruments:

1. Connecticut Trauma Screener (CTS) and
2. the Child and Adolescent Needs and Strengths (CANS). The following documents whether the question is a criteria for PTSD or Depression and other validated trauma screeners that utilized similar questions.

PTSD

1. Had Trouble Sleeping or Bad Dreams:
   • DSM-5 Criteria for PTSD classified under “alterations in arousal and reactivity.” Nightmares are also included under PTSD classified under “intrusion systems.”
   • CTS Question: Trouble Sleeping.
   • CANS asks about disruption in sleep regardless of the cause, including problems going to bed, staying asleep, waking up early, or sleeping too much.

2. Had Trouble Paying Attention or Concentrating: (PTSD and Depression)
   • DSM-5 Criteria for PTSD “difficulty concentrating” This criteria falls under the alterations in arousal and reactivity category.
   • CTS Question: Hard to concentrate or pay attention.
   • CANS: Problems with attention, concentration, and task completion.

3. Felt Alone or not close to people around you:
   • DSM-5 Criteria for PTSD worded as “feeling isolated” classified under “negative alterations in cognition and mood.”
   • CTS Question: Feel alone and not close to people around you.

4. Have you not wanted to be around certain people, places, or things that remind you of upsetting or scary things that have happened?
   • DSM-5 Criteria for PTSD worded as “avoidance of trauma related stimuli after the trauma, in the following way: trauma external reminders.” Under the category of “intrusion symptoms.”
   • CTS Question: Try to stay away from people places, or things that remind you about something that happened.

5. Had uncomfortable feelings when thinking about what has happened (sweating, upset stomach, thumping heart)?
   • DSM-5 Criteria for PTSD worded “Avoidance of trauma related stimuli after the trauma, in the following way: trauma related thoughts or feelings.” Under the category of “intrusion symptoms.”
   • CTS Question: Strong feelings in your body when you remember something that happened (sweating, heart beat fast, feel sick).
   • CCDCI: How often do you remember things you don’t want to remember?

6. Become angry or upset when thinking about things that have happened.
   • DSM-5 Criteria for PTSD under the category of “Alterations in arousal and reactivity.”
   • CANS: The child’s/youth’s ability to identity and manage their anger when frustrated.

7. Used alcohol or drugs to make you feel better?
   • DSM-5 Criteria for PTSD worded “Risky or destructive behavior” under the category of “alterations in arousal and reactivity.”
   • CANS: Child’s/youth’s reaction to any traumatic or adverse childhood experience: use of alcohol and illegal drugs, misuse of prescription medication and the inhalation of any substance for recreational purposes.

Depression According to DSM-5 Criteria

1. Had Trouble Paying Attention or Concentrating: (PTSD and Depression)
   • DSM-5 Criteria for Depression worded “Diminished ability to think or concentrate, or indecisions, nearly every day.”
   • CTS Question: Hard to concentrate or pay attention.
   • CANS: Problems with attention, concentration, and task completion.

2. Blamed yourself or felt guilty for things that have happened?
   • DSM-5 Criteria for depression worded “feelings of worthlessness or excessive or inappropriate guilt nearly every day.”

3. Thought About hurting yourself because you were angry or sad?
   • Similar to DSM-5 criteria for depression worded “recurrent thoughts of death, recurrent suicidal ideation without a specific plan… Those struggling with severe depression may have thoughts of self-harm, death, or suicide, or have a suicide plan.”
   • CANS: “Repetitive, physically harmful behavior that generally serves as a self-soothing function to the child/youth.
   • CCDCI: How often do you think about hurting yourself?

4. Thought About Suicide:
   • DSM-5 Criteria for depression worded: “recurrent thoughts of death, recurrent suicidal ideation without a specific plan… suicide attempt or a specific plan for committing suicide.”
   • CANS: “Suicidal and significant self-injurious behavior.”
   • CCDCI: How often do you think about killing yourself?

5. Feel Sad or Hopeless:
   • DSM-5 Criteria for depression worded “depressed mood most of the day, nearly every day.”
   • CTS Questions: Trouble feeling happy.
   • CANS: “Irritable or depressed mood, social withdrawal, sleep disturbances, weight/eating