Please print this page and circle "Yes" or "No"before each question. A link to a
scoring page is at the bottom of this page.
Yes / No 1. Are you basically satisfied with your life?
Yes / No 2. Have you dropped many of your activities and interests?
Yes / No 3. Do you feel that your life is empty?
Yes / No 4. Do you often get bored?
Yes / No 5. Are you hopeful about the future?
Yes / No 6. Are you bothered by thoughts you can't get out of your head?
Yes / No 7. Are you in good spirits most of the time?
Yes / No 8. Are you afraid something bad is going to happen to you?
Yes / No 9. Do you feel happy most of the time?
Yes / No 10. Do you often feel helpless?
Yes / No 11. Do you often get restless and fidgety?
Yes / No 12. Do you prefer to stay at home, rather than going out and doing new things?
Yes / No 13. Do you frequently worry about the future?
Yes / No 14. Do you feel you have more problems with memory than most?
Yes / No 15. Do you think it is wonderful to be alive now?
Yes / No 16. Do you often feel downhearted and blue?
Yes / No 17. Do you feel pretty worthless the way you are now?
Yes / No 18. Do you worry a lot about the past?
Yes / No 19. Do you find life very exciting?
Yes / No 20. Is it hard for you to get started on new projects?
Yes / No 21. Do you feel full of energy?
Yes / No 22. Do you feel that your situation is hopeless?
Yes / No 23. Do you think that most people are better off than you are?
Yes / No 24. Do you frequently get upset over little things?
Yes / No 25. Do you frequently feel like crying?
Yes / No 26. Do you have trouble concentrating?
Yes / No 27. Do you enjoy getting up in the morning?
Yes / No 28. Do you prefer to avoid social gatherings?
Yes / No 29. Is it easy for you to make decisions?
Yes / No 30. Is your mind as clear as it used to be?