EVERYONE please answer this survey!!?
Please answer with Usually (U), Often (O), Moderately (M), Sometimes (S), Rarely (R), and Never (N). Just put your answers in a little list, exp: R R O S M, etc. Please DO NOT mess around on this, this survey could affect a huge way of thinking about the human mind, I am a REAL Psychotherapist. And please don’t just answer half, answer ALL, it will be anonomous and safe.
Pounding Heart
Sweating
Trembling or Shaking
Shortness of breath
Afraid or scared
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy or unsteady
Fear of losing control or going crazy
Numbness or tingling sensations
Chills or hot flashes
Fear of dying
Constant or persistent worry
Feeling of choking
Unable to relax
Feeling of being unreal
Nervous
Feeling Shaky or wobbly
Irritable or difficulty sleeping
Trembling hands
Avoid situation because of anxiety
Feeling lightheaded or faint
Mind wandering from tasks
Difficult to read written material
Hard to stay focused on conversations
Quick temper
Irritable and get upset easily
Say things without thinking
Make quick decisions without thinking
Tendency to talk first and think later
Moods have highs and lows
Trouble planning
Easily become upset
Many things upset me
Always on the go
More comfortable when moving
Answer questions too fast
Work on more than one project at a time
There is a lot of "static" or "chatter" in my head
Usually moving my hands or feet
Hard to wait my turn
Cluttered mind
Thoughts bounce around my mind
Brain feels as if all the thoughts are flying
Unable to stop daydreaming.
Distressed
At times are talkative or speak faster
More active at times
Very sped up or irritable
Both high and low emotions at the same time
At times is more interested in sex
Self-confidence ranges
GREAT variations in the way I work
Sometimes have been VERY angry or hostile
Mental dullness and very creative thinking
Sudden Social changes
Great optimism or great pessimism
Crying or laughing without a reason
Sharper mind
Less need of sleep
Too many ideas to work easily with
Feeling of pressure to talk
Particularly happy
Too active
Talking too fast
New ideas will not stop coming into my head
Very irritable
Easy to think of jokes and funny stories
Life is a party in your eyes
Full of energy
Think a lot about sex
Feeling particularly playful
have special plans for the world
Spending too much money
My attention jumps
Hard to stay in one place
Do things slowly
Hopeless future
Hard to concentrate on reading
Joy has left my life
Difficulty making decisions
Loss of interest
Feeling sad, blue, and unhappy
Keep moving around
Fatigued
Takes great effort to do simple things
Feeling guilty
Feeling like a failure
Feeling ‘dead’
Disturbed sleep
Think about killing self
Feeling trapped
Feel sad when good things happen to
Weight has changed for unknown reasons
Make self sick because feeling uncomfortably full
Feel like loss of control over eating
Lost 15lbs recently in a 3 month period
Believe that you are too fat
Food dominates your life
Terrified about being overweight
Avoid eating when hungry
Preoccupied with food
Have eating binges
Cut food into small pieces
Aware of the calorie content of foods
Avoid food with a high carbohydrate content
Feel that others would prefer if I ate more
Vomiting after eating
Feel extremely guilty after eating
Preoccupied with a desire to be thinner
Think about burning up calories when exercising
Other people think that I am too thin
Thinking of having fat on my body
Take longer to eat meals
Avoid foods with sugar
Eat diet foods
Feel that food controls my life
Display self-control around food
Feel that others pressure me to eat
Give too much time and thought to food
Feel uncomfortable after eating sweets
Engage in dieting behavior
Like to have an empty stomach
Impulse to vomit after meals
Enjoy trying rich new foods.
Feel that others control my thoughts and feelings
Hearing and seeing things that aren’t there
Feel indescribable
Feel like you have nothing in common with others
Believe in a more fictional world
Others don’t believe what I hear and see
Not able to trust in self’s thoughts
Feeling of having magic powers
Feeling like others are plotting against self
Hard to control thoughts
Treated unfairly by others because of their jealousy
Talking to someone who isn’t there
Okay, I’ll try….
Pounding Heart — S
Sweating — S
Trembling or Shaking — O
Shortness of breath — O
Afraid or scared — O
Chest pain or discomfort — O
Nausea or abdominal distress — S
Feeling dizzy or unsteady — O
Fear of losing control or going crazy — O
Numbness or tingling sensations — O
Chills or hot flashes — R
Fear of dying — U
Constant or persistent worry — O
Feeling of choking — S
Unable to relax — O
Feeling of being unreal — U/O
Nervous — O
Feeling Shaky or wobbly — O
Irritable or difficulty sleeping — S
Trembling hands — S
Avoid situation because of anxiety — O
Feeling lightheaded or faint — S
Mind wandering from tasks — S?
Difficult to read written material — R
Hard to stay focused on conversations — R
Quick temper — R
Irritable and get upset easily — S
Say things without thinking — U!
Make quick decisions without thinking — S
Tendency to talk first and think later — U! O!
Moods have highs and lows — U, I AM a teen…
Trouble planning — O
Easily become upset — O
Many things upset me — O
Always on the go — O
More comfortable when moving — O
Answer questions too fast — S
Work on more than one project at a time — U
There is a lot of "static" or "chatter" in my head — R…
Usually moving my hands or feet — U / O
Hard to wait my turn — S
Cluttered mind — S?
Thoughts bounce around my mind — S…
Brain feels as if all the thoughts are flying — S…
Unable to stop daydreaming — S
Distressed — S
At times are talkative or speak faster — O
More active at times — O
Very sped up or irritable — S?
Both high and low emotions at the same time — S..
At times is more interested in sex — R! nooooo!
Self-confidence ranges — S
GREAT variations in the way I work — S?
Sometimes have been VERY angry or hostile — R
Mental dullness and very creative thinking — Not really… I get all A’s, but think creatively…or so I’m told…?
Sudden Social changes — R
Great optimism or great pessimism — S
Crying or laughing without a reason — S, just crying
Sharper mind — O
Less need of sleep — U
Too many ideas to work easily with — S
Feeling of pressure to talk — U!
Particularly happy — S
Too active — S
Talking too fast — O
New ideas will not stop coming into my head — S
Very irritable — R
Easy to think of jokes and funny stories — U / O, ALL the time
Life is a party in your eyes — S?
Full of energy — S
Think a lot about sex — R! I think about how gross it is!
Feeling particularly playful — S / O
have special plans for the world — R
Spending too much money — U
My attention jumps — S?
Hard to stay in one place — O
Do things slowly — R
Hopeless future — S
Hard to concentrate on reading — R
Joy has left my life — S
Difficulty making decisions — U!
Loss of interest — S
Feeling sad, blue, and unhappy — O
Keep moving around — O
Fatigued — S
Takes great effort to do simple things — R
Feeling guilty — S
Feeling like a failure — O
Feeling ‘dead’ — O
Disturbed sleep — R
Think about killing self — S
Feeling trapped — U
Feel sad when good things happen to — S
Weight has changed for unknown reasons — S / R
Make self sick because feeling uncomfortably full — R
Feel like loss of control over eating — S
Lost 15lbs recently in a 3 month period — Nope
Believe that you are too fat — O
Food dominates your life — Nope / R
Terrified about being overweight — SO true, O / U
Avoid eating when hungry — R
Preoccupied with food — R
Have eating binges — Never…
Cut food into small pieces — R
Aware of the calorie content of foods — S
Avoid food with a high carbohydrate content — R
Feel that others would prefer if I ate more — S
Vomiting after eating — Never
Feel extremely guilty after eating — O
Preoccupied with a desire to be thinner — S, though I’m not really fat yet.
Think about burning up calories when exercising — R
Other people think that I am too thin — R
Thinking of having fat on my body — O
Take longer to eat meals — S
Avoid foods with sugar — R
Eat diet foods — U, cuz my mom works @ weight watchers…
Feel that food controls my life — R
Display self-control around food — S
Feel that others pressure me to eat — R
Give too much time and thought to food — S
Feel uncomfortable after eating sweets — O
Engage in dieting behavior — S
Like to have an empty stomach — R
Impulse to vomit after meals — Never
Enjoy trying rich new foods — sure…
Feel that others control my thoughts and feelings — R
Hearing and seeing things that aren’t there — R, never..
Feel indescribable — U! So true
Feel like you have nothing in common with others — O
Believe in a more fictional world — R
Others don’t believe what I hear and see — R
Not able to trust in self’s thoughts — R
Feeling of having magic powers — never
Feeling like others are plotting against self — R
Hard to control thoughts — R
Treated unfairly by others because of their jealousy — R
Talking to someone who isn’t there — never…
Okay, I hope this helps… it took quite a while…
Good luck.
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