Elevations on this scale suggest that these individuals have experienced an intense life-threatening event that has resulted in extreme fear, helplessness, and arousal. They have reacted by having uncontrolled, intrusive, and recurrent images or emotions related to the event(s): flashbacks, nightmares, or dissociative feelings that reactivate the event(s). Anxiety-related symptoms might include hypervigilance, hyperalertness, overreactive startle reactions, and a compulsive avoidance of circumstances that might be related to the trauma.