Please answer by choosing the appropriate number using the scale below.
Choose the number that describes your feelings most accurately.
0 – Never
1 – Very Little
2 – Moderately
3 – Very Often
4 – Often

1. Are you irritable at work, school, or home?__________
2. Are you tense or critical during meals?__________
3. Do you have difficulty giving praise or expressing thanks to others?__________
4. Do you isolate yourself at home, work, or school?__________
5. Do you initiate quarrelling, or are you often argumentative?________
6. Do you have difficulty trusting people?__________
7. Do you tend to overreact to minor events?_________
8. Do you find yourself trying to control others?__________
9. Are you disappointed with yourself?__________
10. Do you become angry when you reflect on the events of the day?__________