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Circle the appropriate number to show how often you have been troubled by the following:
1 = Occasionally;
2 = Frequently; 0 0 0 0 0 0 1 1 1 1 1 1 2 2 2 2 2 2
3 = 3 3 3 3 3 3
Constantly getting annoyed with people. Difficulty in making decisions. Loss of sense of humour. Suppressed anger. Difficulty concentrating. Inability to finish one task before rushing into another.
2.
3.
4.
5.
6.
7.
8.
0 0
1 1
2 2
3 3
9.
10.
11.
Waking up and feeling tired after an early night. Constant tiredness. Lack of appetite. Craving for food when under pressure. Frequent indigestion or heartburn. Constipation or diarrhoea. Insomnia. Tendency to sweat for no good reason. Nervous twitches, nail biting, etc. Headaches. Cramps and muscle spasms. Nausea.
12.
0 0 0 0 0 0 0 0 0 0 0
1 1 1 1 1 1 1 1 1 1 1
2 2 2 2 2 2 2 2 2 2 2
3 3 3 3 3 3 3 3 3 3 3
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
0 0 0 0
1 1 1 1
2 2 2 2
3 3 3 3
24.
25.
26.