This free survey is powered by
0%
Exit Survey
 
 
In the last month, how often did you feel confident about your ability to handle stress?
 
never
 
almost never
 
sometimes
 
fairly often
 
very often
 
 
 
In the last month, how often did you feel angry because of things out of your control?
 
never
 
almost never
 
sometimes
 
fairly often
 
very often
 
 
 
In the last two weeks, how often have you felt things are going well for you?
 
never
 
almost never
 
sometimes
 
fairly often
 
very often
 
 
 
In the Lat two weeks, how often did you feel you were in control of your life?
 
never
 
almost never
 
sometimes
 
fairly often
 
very often
 
 
 
Sadness
 
0 I do not feel sad
 
1 I feel sad a little
 
2 I am always sad
 
3 I am so sad I cannot stand it
 
 
 
Loss of Pleasure and Enjoyment of life
 
0 I am very pleased and I enjoy life
 
1 I dont enjoy things as much anymore
 
2 I get very little pleasure from things I once enjoyed
 
3 I can no longer do anything that gives me pleasure
 
 
 
Worthlessness
 
0 I do not feel that I am worthless
 
1 I am not as useful anymore
 
2 I am worthless compared to others
 
3 I feel utterly worthless
 
 
 
Irritability
 
0 I am not irritable
 
1 I am slightly more irritable than usual
 
2 I am more irritable than usual
 
3 I am always irritable
 
 
 
Change in Appetite
 
0 I have no change in my appetite
 
1a my appetite is less than usual
 
1b my appetite is greater than usual
 
2a my appetite has increased
 
2b my appetite has decreased
 
3a i have no appetite
 
3b I am always hungry
 
 
 
Considering all parts of my life - physical, emotional, spiritual, and social over the past 2 weeks the quality of my life has been
 
very bad 0 1 2 3 4 5 6 7 8 9 10 excellent
 
Share This Survey:          Online Survey Software Powered by  QuestionPro Survey Software