Result

Mental Health Assessment

Please read each statement and fill in a number 0, 1, 2 or 3 that indicates how much the statement applied to you over the past week.
There are no right or wrong answers. Do not spend too much time on any statement. Just go with your gut feelings.

The rating scale is as follows:

0 - Did not apply to me at all
1 - Applied to me to some degree, or some of the time
2 - Applied to me to a considerable degree, or a good part of time
3 - Applied to me very much, or most of the time

In the past week,

0 1 2 3
1. I found it hard to wind down Missing Item
2. I was aware of dryness of my mouth Missing Item
3. I couldn't seem to experience any positive feeling at all Missing Item
4. I experienced breathing difficulty (e.g. excessively rapid breathing, breathlessness in the absence of physical exertion) Missing Item
5. I found it difficult to work up the initiative to do things Missing Item
6. I tended to over-react to situations Missing Item
7. I experienced trembling (e.g. in the hands) Missing Item
8. I felt that I was using a lot of nervous energy Missing Item
9. I was worried about situations in which I might panic and make a fool of myself Missing Item
10. I felt that I had nothing to look forward to Missing Item
11. I found myself getting agitated Missing Item
12. I found it difficult to relax Missing Item
13. I felt down-hearted and blue Missing Item
14.I was intolerant of anything that kept me from getting on with what I was doing Missing Item
15. I felt I was close to panic Missing Item
16. I was unable to become enthusiastic about anything Missing Item
17. I felt I wasn't worth much as a person Missing Item
18. I felt that I was rather touchy Missing Item
19. I was aware of the action of my heart in the absence of physical exertion (e.g. sense of heart rate increase, heart missing a beat) Missing Item
20. I felt scared without any good reason Missing Item
21. I felt that life was meaningless Missing Item

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