Do you have vague, unexplainable fears?
0 - No
1
2 - Sometimes
3
4 - Yes
Do you get anxious and distressed for no apparent reason?
0 - No
1
2 - Sometimes
3
4 - Yes
Do you wake up feeling that something bad may happen?
0 - No
1
2 - Sometimes
3
4 - Yes
Are you often overwhelmed by your work?
0 - No
1
2 - Sometimes
3
4 - Yes
Do you tend to take on more than you can handle?
0 - No
1
2 - Sometimes
3
4 - Yes
Do you feel that you have enormous responsibilities?
0 - No
1
2 - Sometimes
3
4 - Yes
Have you lost hope that you will recover from an illness?
0 - No
1
2 - Sometimes
3
4 - Yes
Do you feel it is useless to seek further help for your problems?
0 - No
1
2 - Sometimes
3
4 - Yes
Have you given up hope that things will change for the better?
0 - No
1
2 - Sometimes
3
4 - Yes
Are you in a relationship you cannot break away from?
0 - No
1
2 - Sometimes
3
4 - Yes
Are you currently in a state of change or transition?
0 - No
1
2 - Sometimes
3
4 - Yes
Is it difficult to let go of the past to start something new?
0 - No
1
2 - Sometimes
3
4 - Yes
Have there been past shocks or traumas in your life?
0 - No
1
2 - Sometimes
3
4 - Yes
Do you feel as if you haven't fully recovered from them?
0 - No
1
2 - Sometimes
3
4 - Yes
