| Over the last 2 weeks, how often have you been bothered by any of the following problems? |
| 1. Feeling nervous, anxious, or on edge |
|
| 2. Feeling down, depressed, or hopeless |
|
| 3. Not being able to stop or control worrying |
|
| 4. Feeling bad about yourself - or that you are a failure or have let yourself or your family down |
|
| 5. Thoughts that you would be better off dead or of hurting yourself in some way |
|
| 6. Trouble concentrating on things, such as reading the newspaper or watching television |
|
| 7. Trouble falling or staying asleep, or sleeping too much |
|
| 8. Trouble relaxing |
|
| 9. Being so restless that it is hard to sit still |
|
| 10. Feeling afraid, as if something awful
might happen |
|
| 11. Worrying too much about different things |
|
| 12. Poor appetite or overeating |
|
| 13. Feeling tired or having little energy |
|
| 14. Moving or speaking so slowly that other people could have noticed? Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual |
|
| 15. Becoming easily annoyed or irritable |
|
| 16. Little interest or pleasure in doing things |
|