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Distress
In the past month, how often did you feel anxious or tense?
In the past month, how often did you feel nervous?
In the past month, how often did you feel restless or fidgety?
In the past month, how often did you feel sad or depressed?
In the past month, how often did you feel hopeless?
Anger
In the past month, how often did you feel annoyed or frustrated?
In the past month, how often did you feel angry?
In the past month, how often did you yell at someone or something?
Sleep Problems
In the past month, how often did you have trouble falling or staying asleep?
In the past month, how often did you wake up before you wanted to?
In the past month, how often did you wake up feeling refreshed?
Loneliness
In the past month, how often did you feel like you lacked companionship?
In the past month, how often did you feel left out?
In the past month, how often did you feel isolated from other people?
Mastery
You have little control over the things that happen to you.
There is really no way you can solve some of the problems you have.
You often feel helpless in dealing with problems of life.
Sometimes you feel that you are being pushed around in life.