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Click the button to start your screening for GAD...

A Screening for Generalized Anxiety Disorder (GAD)

AND if not Ben, please know that it is OK to help yourself by using this link to locate a different specialist who treats GAD and other emotional disorders. Visit the ADAA Find a Therapist

*Reference:
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC, American Psychiatric Association, 1994. This assessment tool may be reproduced, translated, displayed or distributed, without asking for permission.

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Question 1 of 12

  1. Over the last several months, have you been continually worried or anxious about a number of events or activities in your daily life? 

A

Yes

B

No

Question 2 of 12

Are you troubled by the following?

  1. Excessive worry, occurring more days than not, for a least six months
  2. Unreasonable worry about events or activities, such as work, school, or your health
  3. The inability to control the worry

(Select all that apply)
A

Yes - Excessive worry, occurring more days than not, for a least six months

B

No - Excessive worry, occurring more days than not, for a least six months

C

Yes - Unreasonable worry about events or activities, such as work, school, or your health

D

No - Unreasonable worry about events or activities, such as work, school, or your health

E

Yes - The inability to control the worry

F

No - The inability to control the worry

Question 3 of 12

Are you bothered by at least three of the following?

  1. Restlessness, feeling keyed-up, or on edge
  2. Being easily tired
  3. Problems concentrating
  4. Irritability
  5. Muscle tension
  6. Trouble falling or staying asleep, or restless and unsatisfying sleep
  7. Your anxiety interfering with your daily life

(Select all that apply)
A

Yes - 1 - Restlessness, feeling keyed-up, or on edge

B

No - 1 - Restlessness, feeling keyed-up, or on edge

C

Yes - 2 - Being easily tired

D

No - 2 - Being easily tired

E

Yes - 3 - Problems concentrating

F

No - 3 - Problems concentrating

G

Yes - 4 - Irritability

H

No - 4 - Irritability

I

Yes - 5 - Muscle tension

J

No - 5 - Muscle tension

K

Yes - 6 - Trouble falling or staying asleep, or restless and unsatisfying sleep

L

No - 6 - Trouble falling or staying asleep, or restless and unsatisfying sleep

M

Yes - 7 - Your anxiety interfering with your daily life

N

No - 7 - Your anxiety interfering with your daily life

Question 4 of 12

Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Depression and substance abuse are among the conditions that occasionally complicate anxiety disorders.

 

  1. Have you experienced changes in sleeping or eating habits?

A

Yes

B

No

Question 5 of 12

Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Depression and substance abuse are among the conditions that occasionally complicate anxiety disorders.

 

More days than not, do you feel:

  1. sad or depressed?
  2. disinterested in life?
  3. worthless or guilty?

(Select all that apply)
A

Yes - 1 - sad or depressed?

B

No - 1 - sad or depressed?

C

Yes - 2 - disinterested in life?

D

No - 2 - disinterested in life?

E

Yes - 3 - worthless or guilty?

F

No - 3 - worthless or guilty?

Question 6 of 12

 

Having more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Depression and substance abuse are among the conditions that occasionally complicate anxiety disorders.

 

During the last year, has the use of alcohol or drugs...

  1. resulted in your failure to fulfill responsibilities with work, school, or family?
  2. placed you in a dangerous situation, such as driving a car under the influence?
  3. gotten you arrested?
  4. continued despite causing problems for you or your loved ones?

(Select all that apply)
A

Yes - 1 - resulted in your failure to fulfill responsibilities with work, school, or family?

B

No - 1 - resulted in your failure to fulfill responsibilities with work, school, or family?

C

Yes - 2 - placed you in a dangerous situation, such as driving a car under the influence?

D

No - 2 - placed you in a dangerous situation, such as driving a car under the influence?

E

Yes - 3 - gotten you arrested?

F

No - 3 - gotten you arrested?

G

Yes - 4 - continued despite causing problems for you or your loved ones?

H

No - 4 - continued despite causing problems for you or your loved ones?

Question 7 of 12

The following 6 questions are about discovering the role anxiety plays in your life. To help us achieve the results

you want and deserve, please complete the following questionnaire.

 

1) Which condition(s) best describes what you are experiencing.

 

(Select all that apply)
A

AGORAPHOBIA

B

OCD

C

PANIC

D

DEPRESSION

E

PTSD

F

GAD

G

SOCIAL ANXIETY

H

SPECIFIC PHOBIAS

Question 8 of 12

 

2) Describe examples of how you know that you suffer from this condition?

Question 9 of 12

 

3) How does this condition affect your daily living?

Question 10 of 12

 

4) What have you done to treat this condition to date?

Question 11 of 12

5) Why do you think you developed this condition?

Question 12 of 12

 

6) On a scale of 1-10 how would you rate your life in general?

A

1

B

2

C

3

D

4

E

5

F

6

G

7

H

8

I

9

J

10!

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