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Answer the following questions: |
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YES |
CLICK HERE |
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1 |
Do you worry excessively about a number of
events or activities? |
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J |
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2 |
Do you ever experience short periods of time of intense
fear accompanied by physical symptoms like shortness of
breath, palpitations or sweating? |
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J
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3 |
Do you ever experience anxiety about
being in a crowd, on a bridge, traveling on public
transportation ? |
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J
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4 |
Do you experience intrusive thoughts that are not simply excessive
worries about real life problems and do you perform repetitively some
behavior (hand washing, checking) in response to the thoughts? |
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J
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5 |
Do you have fear of social situations in which
you are exposed to strangers or to scrutiny by others ? |
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J
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6 |
Have you ever been exposed to a traumatic
event in which you experienced intense fear, helplessness or horror
and now you feel anxious when exposed to cues that symbolize or
resemble the event? |
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J
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7 |
Do you feel depressed, did you lose interest
in things you used to enjoy, do you have low self esteem, do you have
problems sleeping or with your appetite? |
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J |
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8 |
Do you have periods of feeling very happy or
of being
irritable/angry, with high energy and no need for sleep? |
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J |
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9 |
Are you excessively preoccupied with an imagined
defect or a slight physical anomaly? |
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J
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10 |
Do you have intense fear of weight gain or of being fat even
though underweight? |
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J |
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11 |
Have you ever tried to stop drinking and failed? Has your drinking
caused you problems at home or work? Did you get in trouble because
of your drinking? |
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J
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12 |
Does your relative have worsening memory, poor judgement and
impulse control; is he/she angry and hostile and gets lost often? |
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J
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13 |
Does your child experience several of the following symptoms:
inattention, distractibility, forgetfulness, hyperactivity, inability
to sit still ? |
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J |
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14 |
Is your child angry, hostile, touchy and vindictive; does he annoy
and blame others? |
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J |
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15 |
Is your child aggressive to people and animals, does he destroy
property, lie, steal, disobey rules?
01/26/01
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J |