Scored measures are self-report assessment tools that can be used to screen for mental health conditions and evaluate treatment progress. In this guide, you can learn more about the questions each measure includes and how scores are calculated.
The following scored measures are available in SimplePractice:
- GAD-7
- PHQ-9
- PHQ-15
- PCL-5
- AUDIT
- AUDIT-C Plus 3
- WSAS
- PEG
- Y-BOCS
- SWLS
- ICG
- DSS-B
- SF-20
- FS
- ARM-5
- DASS-21
- C-SSRS
- ASRS-v1.1
- CDC HRQOL- 4 Plus 1
- WHODAS 2.0
- SP-GAM
- OCI-R
Note: To learn more about scored measures, see Getting started with measurement-based care.
GAD-7
The Generalized Anxiety Disorder 7-item scale, or GAD-7, is a tool designed to measure the presence and severity of anxiety. It includes the following questions:
| Over the last 2 weeks, how often have you been bothered by the following problems? | ||||
| 1. Feeling nervous, anxious, or on edge | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 2. Not being able to stop or control worrying | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 3. Worrying too much about different things | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 4. Trouble relaxing | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 5. Being so restless that it’s hard to sit still | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 6. Becoming easily annoyed or irritable | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 7. Feeling afraid as if something awful might happen | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| If you checked off any problems, how difficult have these made it for you to do your work, take care of things at home, or get along with other people? | Not difficult at all | Somewhat difficult | Very difficult | Extremely difficult |
The GAD-7 is calculated by assigning a score of 0, 1, 2, or 3 to the answers to questions 1-7, and the total score ranges from 0 to 21.
| Score | Anxiety severity |
| 0-4 | None-minimal |
| 5-9 | Mild |
| 10-14 | Moderate |
| 15-21 | Severe |
Source
- Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine, 166(10), 1092–1097.
PHQ-9
The Patient Health Questionnaire-9, or PHQ-9, is a tool designed to measure the presence and severity of depression. It includes the following questions:
| Over the last 2 weeks, how often have you been bothered by any of the following? | ||||
| 1. Little interest or pleasure in doing things | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 2. Feeling down, depressed, or hopeless | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 3. Trouble falling or staying asleep, or sleeping too much | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 4. Feeling tired or having little energy | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 5. Poor appetite or overeating | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 6. Feeling bad about yourself—or that you are a failure or have let yourself or your family down | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 7. Trouble concentrating on things, such as reading the newspaper or watching television | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 8. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 9. Thoughts that you would be better off dead or of hurting yourself in some way | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? | Not difficult at all | Somewhat difficult | Very difficult | Extremely difficult |
The PHQ-9 is calculated by assigning scores of 0, 1, 2, or 3 to answers for questions 1-9, and the total score ranges from 0 to 27.
| Score | Depression severity |
| 0-4 | None-minimal |
| 5-9 | Mild |
| 10-14 | Moderate |
| 15-19 | Moderately Severe |
| 20-27 | Severe |
Source
- Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32(9), 509–515.
PHQ-15
The Patient Health Questionnaire Physical Symptoms, or PHQ-15, is a tool designed to assess somatic symptom severity and the potential presence of somatization and somatoform disorders. It includes the following questions:
| During the past 4 weeks, how much have you been bothered by any of the following problems? | ||||
| 1. Stomach pain | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 2. Back pain | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 3. Pain in your arms, legs, or joints (knees, hips, etc.) | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 4. Menstrual cramps or other problems with your periods | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | Not applicable (0) |
| 5. Headaches | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 6. Chest pain | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 7. Dizziness | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 8. Fainting spells | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 9. Feeling your heart pound or race | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 10. Shortness of breath | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 11. Pain or problems during sexual intercourse | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 12. Constipation, loose bowels, or diarrhea | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 13. Nausea, gas, or indigestion | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 14. Feeling tired or having low energy | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
| 15. Trouble sleeping | Not bothered at all (0) | Bothered a little (1) | Bothered a lot (2) | |
The PHQ-15 is calculated by assigning a score of 0, 1, or 2, to the answers to questions 1-15, and the total score ranges from 0 to 30.
| Score | Somatic Symptom severity |
| 0–4 | Minimal |
| 5–9 | Low |
| 10–14 | Medium |
| 15–30 | High |
Source
- Kroenke, K., Spitzer, R. L., & Williams, J. B. (2002). The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine, 64(2), 258–266.
PCL-5
The PTSD Checklist for DSM-5, or PCL-5, is a tool designed to measure the presence and severity of Post-Traumatic Stress Disorder (PTSD) symptoms. It includes the following questions:
| In the past month, how much were you bothered by: | |||||
| 1. Repeated, disturbing, and unwanted memories of the stressful experience? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 2. Repeated, disturbing dreams of the stressful experience? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 3. Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 4. Feeling very upset when something reminded you of the stressful experience? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 5. Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 6. Avoiding memories, thoughts, or feelings related to the stressful experience? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 7. Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 8. Trouble remembering important parts of the stressful experience? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 9. Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 10. Blaming yourself or someone else for the stressful experience or what happened after it? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 11. Having strong negative feelings such as fear, horror, anger, guilt, or shame? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 12. Loss of interest in activities that you used to enjoy? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 13. Feeling distant or cut off from other people? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 14. Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 15. Irritable behavior, angry outbursts, or acting aggressively? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 16. Taking too many risks or doing things that could cause you harm? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 17. Being “superalert” or watchful or on guard? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 18. Feeling jumpy or easily startled? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 19. Having difficulty concentrating? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
| 20. Trouble falling or staying asleep? | Not at all (0) | A little bit (1) | Moderately (2) | Quite a bit (3) | Extremely (4) |
The PCL-5 is calculated by assigning a score of 0, 1, 2, 3, or 4 to the answers to questions 1-20, and the total score ranges from 0 to 80.
| Score | PTSD severity |
| 0–31 | Below clinical threshold |
| 32–80 | Above clinical threshold |
Source
- Weathers, F.W., Litz, B.T., Keane, T.M., Palmieri, P.A., Marx, B.P., & Schnurr, P.P. (2013). The PTSD Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD.
AUDIT
The Alcohol Use Disorders Identification Test: Self-Report Version, or AUDIT, is a tool designed to screen for excessive alcohol consumption, consequences of drinking, and alcohol related symptoms. It includes the following questions:
| Select the option that best describes your answer to each question: | |||||
| 1. How often do you have a drink containing alcohol? | Never (0) | Monthly or less (1) | 2-4 times a month (2) | 2-3 times a week (3) | 4 or more times a week (4) |
| 2. How many drinks containing alcohol do you have on a typical day when you are drinking? | 1 or 2 (0) | 3 or 4 (1) | 5 or 6 (2) | 7 to 9 (3) | 10 or more (4) |
| 3. How often do you have six or more drinks on one occasion? | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) |
| 4. How often during the last year have you found that you were not able to stop drinking once you had started? | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) |
| 5. How often during the last year have you failed to do what was normally expected of you because of drinking? | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) |
| 6. How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session? | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) |
| 7. How often during the last year have you had a feeling of guilt or remorse after drinking? | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) |
| 8. How often during the last year have you been unable to remember what happened the night before because of your drinking? | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) |
| 9. Have you or someone else been injured because of your drinking? | No (0) | Yes, but not in the last year (2) | Yes, during the last year (4) | ||
| 10. Has a relative, friend, doctor, or other health care worker been concerned about your drinking or suggested you cut down? | No (0) | Yes, but not in the last year (2) | Yes, during the last year (4) | ||
The AUDIT is calculated by assigning a score of 0, 1, 2, 3, or 4 to the answers to questions 1-8, and a score of 0, 2, or 4 to questions 9 and 10. The total score ranges from 0 to 40.
| Score | Risk category | Interpretation content |
| 0–7 | Zone I | Low-risk drinking or abstinence |
| 8-15 | Zone II | At-risk use |
| 16-19 | Zone III | Harmful and hazardous use |
| 20-40 | Zone IV | Possible substance use disorder |
The AUDIT can be broken into 3 conceptual domains:
- Alcohol consumption (items 1-3)
- Alcohol-related symptoms (items 4-6)
- Alcohol-related harm (7-10)
Sources
- Babor, T. F. , Higgins-Biddle, J. C. , Saunders, J. B. , Monteiro, M. G. , & World Health Organization. (2001). AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for use in primary health care (2nd ed.). Geneva, Switzerland: World Health Organization.
- Saunders, J. B., Aasland, O. G., Babor, T. F., De La Fuente, J. R., & Grant, M. (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II. Addiction, 88(6), 791–804.
AUDIT-C Plus 3
The AUDIT-C Plus 3 (Alcohol and Substance Use Questionnaire) includes items to screen for the excessive consumption of alcohol and other substances, such as tobacco and marijuana. It includes the following questions:
| Select the option that best describes your answer to each question: | ||||||
| 1. How often did you have a drink containing alcohol? | Never (0) | Monthly or less (1) | 2 to 4 times a month (2) | 2 to 3 times a week (3) | 4 or more times a week (4) | |
| 2. How many drinks containing alcohol did you have on a typical day when you were drinking? | Never (0) | 1 or 2 (0) | 3 or 4 (1) | 5 or 6 (2) | 7 or 9 (3) | 10 or more (4) |
| 3. How often did you have 5 or more drinks on one occasion? | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) | |
| 4. How often have you used marijuana? This includes any cannabis products with THC, including edibles and concentrates. | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) | |
| 5. How often have you used an illegal drug or used a prescription medication for non-medical reasons? This includes cocaine, prescription painkillers, hallucinogens, heroin, etc. | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) | |
| 6. How often have you used tobacco or used products containing nicotine for reasons other than quitting tobacco? This includes products like e-cigarettes, hookah, dip, and cigars. | Never (0) | Less than monthly (1) | Monthly (2) | Weekly (3) | Daily or almost daily (4) | |
The AUDIT-C Plus 3 is calculated by assigning a score of 0, 1, 2, 3, or 4 to the answers to questions 1-6. Each question corresponds to a cluster:
- Alcohol use (questions 1-3)
- Cannabis use (question 4)
- Other drug use (question 5)
- Tobacco use (question 6)
To interpret scores for each cluster, see the tables below:
Alcohol use
| Score | Severity |
| 0 - 2 | Low-risk drinking or abstinence |
| 3 | Low-risk drinking (in males assigned at birth) or regular drinking that can impact health (in females assigned at birth) |
| 4 - 6 | Regular drinking that can impact health |
| 7 - 12 | Drinking that is more likely to impact health |
Cannabis use
| Score | Severity |
| 0 - 1 | Low-risk use or abstinence |
| 2 - 3 | Regular use that can impact health |
| 4 | Use that is more likely to impact health |
Other drug use
| Score | Severity |
| 0 | Low-risk use or abstinence |
| 1 - 4 | Low-risk use or abstinence |
Tobacco use
| Score | Severity |
| 0 - 1 | Low-risk use or abstinence |
| 2 - 3 | Regular use that can impact health |
| 4 | Use that is more likely to impact health |
Sources
- Bradley, K. A., Chung, H., Brown, R. L., Farley, T., Fischer, L., & Goplerud, E. (2018). Implementing care for alcohol and other drug use in medical settings: An extension of SBIRT. Washington, DC: National Council for Behavioral Health.
- Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Archives of Internal Medicine, 158(16), 1789–1795.
WSAS
The Work and Social Adjustment scale, or WSAS, is a tool designed to measure how one’s mental health affects the ability to do certain day-to-day tasks. It includes the following statements:
| On a scale, rate how much your mental health impairs your ability to carry out the following activities: | |||||||||
| 1. Because of my mental health, my ability to work is impaired. | 0 (Not at all) | 1 | 2 (Slightly) | 3 | 4 (Definitely) | 5 | 6 (Markedly) | 7 | 8 (Very severely) |
| 2. Because of my mental health, my home management (cleaning, tidying, shopping, cooking, looking after home or children, paying bills) is impaired. | 0 (Not at all) | 1 | 2 (Slightly) | 3 | 4 (Definitely) | 5 | 6 (Markedly) | 7 | 8 (Very severely) |
| 3. Because of my mental health, my social leisure activities (with other people e.g. parties, bars, clubs, outings, visits, dating, home entertaining) are impaired. | 0 (Not at all) | 1 | 2 (Slightly) | 3 | 4 (Definitely) | 5 | 6 (Markedly) | 7 | 8 (Very severely) |
| 4. Because of my mental health, my private leisure activities (done alone, such as reading, gardening, collecting, sewing, walking alone) are impaired. | 0 (Not at all) | 1 | 2 (Slightly) | 3 | 4 (Definitely) | 5 | 6 (Markedly) | 7 | 8 (Very severely) |
| 5. Because of my mental health, my ability to form and maintain close relationships with others, including those I live with, is impaired. | 0 (Not at all) | 1 | 2 (Slightly) | 3 | 4 (Definitely) | 5 | 6 (Markedly) | 7 | 8 (Very severely) |
The WSAS is calculated by assigning a score of 0-8 to the answers to statements 1-5, and the total score ranges from 0 to 40.
| Score | Functional impairment severity |
| 0-9 | None or subclinical |
| 10-19 | Significant |
| 20-40 | Moderately severe |
Source
- Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. H. (2002). The Work and Social Adjustment Scale: A simple measure of impairment in functioning. The British Journal of Psychiatry: The Journal of Mental Science, 180, 461–464.
PEG
The Pain, Enjoyment, General Activities scale, or PEG, is a tool designed to assess pain intensity and interference. It includes the following questions:
| 1. What number best describes your pain on average in the past week? | 0 (No pain) | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 (Pain as bad as you can imagine) |
| 2. What number best describes how, during the past week, pain has interfered with your enjoyment of life? | 0 (Does not interfere) | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 (Completely interferes) |
| 3. What number best describes how, during the past week, pain has interfered with your general activity? | 0 (Does not interfere) | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 (Completely interferes) |
The PEG is calculated by assigning a score of 0-10 to the answers to questions 1-3, and the total score ranges from 0 to 10. To calculate the score, first find the average by dividing the sum of points by the total number of questions (for example, 30 points divided by 3 equals 10), then round to the nearest tenth.
| Score | Pain severity |
| 0-3.9 | Mild pain |
| 4-6.9 | Moderate pain |
| 7-10 | Severe pain |
Source
- Krebs, E. E., Lorenz, K. A., Bair, M. J., Damush, T. M., Wu, J., Sutherland, J. M., Asch, S. M., & Kroenke, K. (2009). Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference. Journal of General Internal Medicine, 24(6), 733–738.
Y-BOCS
The Yale-Brown Obsessive Compulsive Scale, or Y-BOCS, is a tool designed to measure obsessive-compulsive disorder (OCD) symptom severity and treatment response. It includes the following:
Obsessions
Obsessions are unwanted ideas, images or impulses that intrude on thinking against your wishes and efforts to resist them. They usually involve themes of harm, risk and danger. Common obsessions are excessive fears of contamination; recurring doubts about danger, extreme concern with order, symmetry, or exactness; fear of losing important things.
| Please answer each question: | |||||
|
1. Time occupied by obsessive thoughts How much of your time is occupied by obsessive thoughts? |
None (0) | Less than 1 hr/day or occasional occurrence (1) | 1 to 3 hrs/day or frequent (2) | Greater than 3 and up to 8 hrs/day or very frequent occurrence (3) | Greater than 8 hrs/day or nearly constant occurrence (4) |
|
2. Interference due to obsessive thoughts How much do your obsessive thoughts interfere with your work, school, social, or other important role functioning? Is there anything that you don’t do because of them? |
None (0) | Slight interference with social or other activities, but overall performance not impaired (1) | Definite interference with social or occupational performance, but still manageable (2) | Causes substantial impairment in social or occupational performance (3) | Incapacitating (4) |
|
3. Distress associated with obsessive thoughts How much distress do your obsessive thoughts cause you? |
None (0) | Not too disturbing (1) | Disturbing, but still manageable (2) | Very disturbing (3) | Near constant and disabling distress (4) |
|
4. Resistance against obsessions How much of an effort do you make to resist the obsessive thoughts? How often do you try to disregard or turn your attention away from these thoughts as they enter your mind? |
Try to resist all the time (0) | Try to resist most of the time (1) | Make some effort to resist (2) | Yield to all obsessions without attempting to control them, but with some reluctance (3) | Completely and willingly yield to all obsessions (4) |
|
5. Degree of control over obsessive thoughts How much control do you have over your obsessive thoughts? How successful are you in stopping or diverting your obsessive thinking? Can you dismiss them? |
Complete control (0) | Usually able to stop or divert obsessions with some effort and concentration (1) | Sometimes able to stop or divert obsessions (2) | Rarely successful in stopping or dismissing obsessions, can only divert attention with difficulty (3) | Obsessions are completely involuntary, rarely able to even momentarily alter obsessive thinking (4) |
Compulsive behaviors
Compulsions are urges that people have to do something to lessen feelings of anxiety or other discomfort. Often they do repetitive, purposeful, intentional behaviors called rituals. The behavior itself may seem appropriate but it becomes a ritual when done to excess. Washing, checking, repeating, straightening, hoarding and many other behaviors can be rituals. Some rituals are mental. For example, thinking or saying things over and over under your breath.
| Please answer each question: | |||||
|
6. Time spent performing compulsive behaviors How much time do you spend performing compulsive behaviors? How much longer than most people does it take to complete routine activities because of your rituals? How frequently do you do rituals? |
None (0) | Less than 1 hr/day, or occasional performance of compulsive behaviors (1) | From 1 to 3 hrs/day, or frequent performance of compulsive behaviors (2) | More than 3 and up to 8 hrs/day, or very frequent performance of compulsive behaviors (3) | More than 8 hrs/day, or near constant performance of compulsive behaviors (too numerous to count) (4) |
|
7. Interference due to compulsive behaviors How much do your compulsive behaviors interfere with your work, school, social, or other important role functioning? Is there anything that you don’t do because of the compulsions? |
None (0) | Slight interference with social or other activities, but overall performance not impaired (1) | Definite interference with social or occupational performance, but still manageable (2) | Causes substantial impairment in social or occupational performance (3) | Incapacitating (4) |
|
8. Distress associated with compulsive behavior How would you feel if prevented from performing your compulsion(s)? How anxious would you become? |
None (0) | Only slightly anxious if compulsions prevented (1) | Anxiety would mount but remain manageable if compulsions prevented (2) | Prominent and very disturbing increase in anxiety if compulsions interrupted (3) | Incapacitating anxiety from any intervention aimed at modifying activity (4) |
|
9. Resistance against compulsions How much of an effort do you make to resist the compulsions? |
Always try to resist (0) | Try to resist most of the time (1) | Make some effort to resist (2) | Yield to all compulsions without attempting to control them, but with some reluctance (3) | Completely and willingly yield to all compulsions (4) |
|
10. Degree of control over compulsive behavior How strong is the drive to perform the compulsive behavior? How much control do you have over the compulsions? |
Complete control (0) | Pressure to perform the behavior but usually able to exercise voluntary control over it (1) | Strong pressure to perform behavior, can control it only with difficulty (2) | Very strong drive to perform behavior, must be carried to completion, can only delay with difficulty (3) | Drive to perform behavior experienced as completely involuntary and over-powering, rarely able to even momentarily delay activity (4) |
The Y-BOCS is calculated by assigning a score of 0, 1, 2, 3, or 4 to the answers to questions 1-10, and the total score ranges from 0 to 40.
| Score | Obsessive-compulsive disorder |
| 0–7 | No or sub-clinical |
| 8–15 | Mild |
| 16–23 | Moderate |
| 24–31 | Severe |
| 34–40 | Extreme |
Source
- Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., Heninger, H. R., & Charney, D. S. (1989). The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Archives of General Psychiatry, 46(11), 1006–1011.
SWLS
The Satisfaction With Life Scale, or SWLS, is a tool designed to measure global cognitive judgments of satisfaction with one’s life. It includes the following:
| On a scale from 1 to 7, indicate your agreement with each item: | |||||||
| 1. In most ways my life is close to my ideal. | Strongly disagree (1) | Disagree (2) | Slightly disagree (3) | Neither agree nor disagree (4) | Slightly agree (5) | Agree (6) | Strongly agree (7) |
| 2. The conditions of my life are excellent. | Strongly disagree (1) | Disagree (2) | Slightly disagree (3) | Neither agree nor disagree (4) | Slightly agree (5) | Agree (6) | Strongly agree (7) |
| 3. I am satisfied with my life. | Strongly disagree (1) | Disagree (2) | Slightly disagree (3) | Neither agree nor disagree (4) | Slightly agree (5) | Agree (6) | Strongly agree (7) |
| 4. So far I have gotten the important things I want in life. | Strongly disagree (1) | Disagree (2) | Slightly disagree (3) | Neither agree nor disagree (4) | Slightly agree (5) | Agree (6) | Strongly agree (7) |
| 5. If I could live my life over, I would change almost nothing. | Strongly disagree (1) | Disagree (2) | Slightly disagree (3) | Neither agree nor disagree (4) | Slightly agree (5) | Agree (6) | Strongly agree (7) |
The SWLS is calculated by assigning a score of 1, 2, 3, 4, 5, 6, or 7 to the answers to questions 1-5, and the total score ranges from 0 to 35.
| Score | Satisfaction ratings |
| 5–9 | Extremely dissatisfied |
| 10–14 | Dissatisfied |
| 15–19 | Slightly dissatisfied |
| 20–24 | Average |
| 25–29 | Satisfied |
| 30–35 | Highly satisfied |
Source
- Kobau, R., Sniezek, J., Zack, M. M., Lucas, R. E., & Burns, A. (2010). Well‐being assessment: An evaluation of well‐being scales for public health and population estimates of well‐being among US adults. Applied Psychology: Health and Well-being, 2(3), 272-297.
ICG
The Inventory of Complicated Grief, or ICG, is a tool designed to measure symptoms of complicated grief in bereaved individuals. It includes the following:
| Please answer the following questions with regards to a person in your life who has died: | |||||
| 1. I think about this person so much that it’s hard for me to do things I normally do | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 2. Memories of the person who died upset me | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 3. I cannot accept the death of the person who died | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 4. I feel myself longing for the person who died | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 5. I feel drawn to places and things associated with the person who died | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 6. I can’t help feeling angry about their death | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 7. I feel disbelief over what happened | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 8. I feel stunned or dazed over what happened | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 9. Ever since they died it is hard for me to trust people | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 10. Ever since they died I feel like I have lost the ability to care about other people or I feel distant from people I care about | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 11. I have pain in the same area of my body or I have some of the same symptoms as the person who died | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 12. I go out of my way to avoid reminders of the person who died | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 13. I feel that life is empty without the person who died | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 14. I hear the voice of the person who died speak to me | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 15. I see the person who died stand before me | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 16. I feel that it is unfair that I should live when this person died | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 17. I feel bitter over this person’s death | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 18. I feel envious of others who have not lost someone close | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
| 19. I feel lonely a great deal of the time ever since they died | Never (0) | Rarely (1) | Sometimes (2) | Often (3) | Always (4) |
The ICG is calculated by assigning a score of 0, 1, 2, 3, or 4 to the answers to questions 1 - 19, and the total score ranges from 0 to 76.
Scores above 25 may indicate considerable impairment in social, general, mental, or physical health functioning, or in bodily pain.
Source
- Prigerson, H. G., Maciejewski, P. K., Reynolds, C. F., 3rd, Bierhals, A. J., Newsom, J. T., Fasiczka, A., Frank, E., Doman, J., & Miller, M. (1995). Inventory of Complicated Grief: a scale to measure maladaptive symptoms of loss. Psychiatry research, 59(1-2), 65–79.
DSS-B
The Brief Dissociative Symptoms Scale, or DSS-B, is a tool designed to measure symptoms of dissociation. It includes the following:
| Indicate how much each thing has happened to you in the past week. | |||||
| 1. Things around me seemed strange or unreal. | Not at all (0) | Once or twice (1) | Almost every day (2) | About once a day (3) | More than once a day (4) |
| 2. I had moments when I lost control and acted like I was back in an upsetting time in my past. | Not at all (0) | Once or twice (1) | Almost every day (2) | About once a day (3) | More than once a day (4) |
| 3. I heard something that I know really wasn’t there. | Not at all (0) | Once or twice (1) | Almost every day (2) | About once a day (3) | More than once a day (4) |
| 4. I felt like I was in a movie – like nothing that was happening was real. | Not at all (0) | Once or twice (1) | Almost every day (2) | About once a day (3) | More than once a day (4) |
| 5. I saw something that seemed real, but was not. | Not at all (0) | Once or twice (1) | Almost every day (2) | About once a day (3) | More than once a day (4) |
| 6. I suddenly realized that I hadn’t been paying attention to what was going on around me. | Not at all (0) | Once or twice (1) | Almost every day (2) | About once a day (3) | More than once a day (4) |
| 7. I reacted to people or situations as if I were back in an upsetting time in my past. | Not at all (0) | Once or twice (1) | Almost every day (2) | About once a day (3) | More than once a day (4) |
| 8. I got so focused on something going on in my mind that I lost track of what was happening around me. | Not at all (0) | Once or twice (1) | Almost every day (2) | About once a day (3) | More than once a day (4) |
The DSS-B is calculated by assigning a score of 0, 1, 2, 3, or 4 to the answers to questions 1 - 8 and the total score ranges from 0 to 32. Higher scores are indicative of more symptoms of dissociation.
Source
- Macia, K. S., Carlson, E. B., Palmieri, P. A., Smith, S. R., Anglin, D. M., Ghosh Ippen, C., Lieberman, A. F., Wong, E. C., Schell, T. L., & Waelde, L. C. (2023). Development of a Brief Version of the Dissociative Symptoms Scale and the reliability and validity of DSS-B scores in diverse clinical and community samples. Assessment, 30(7), 2058–2073.
SF-20
The Medical Outcomes Study: 20-Item Short Form Survey Instrument, or SF-20, is a tool designed to measure health across six dimensions. It includes the following:
|
Select one option for each questionnaire item. |
|||||
| 1. In general, would you say your health is: | Poor (0) | Fair (1.99) | Good (3.43) | Very good (4.36) | Excellent (5) |
| For how long (if at all) has your health limited you in each of the following activities? | ||||||||
| 2. The kinds or amounts of vigorous activities you can do, like lifting heavy objects, running or participating in strenuous sports | Limited for more than 3 months (1) | Limited for 3 months or less (2) | Not limited at all (3) | |||||
| 3. The kinds or amounts of moderate activities you can do, like moving a table, carrying groceries, or bowling | Limited for more than 3 months (1) | Limited for 3 months or less (2) | Not limited at all (3) | |||||
| 4. Walking uphill or climbing a few flights of stairs | Limited for more than 3 months (1) | Limited for 3 months or less (2) | Not limited at all (3) | |||||
| 5. Bending, lifting, or stooping | Limited for more than 3 months (1) | Limited for 3 months or less (2) | Not limited at all (3) | |||||
| 6. Walking one block | Limited for more than 3 months (1) | Limited for 3 months or less (2) | Not limited at all (3) | |||||
| 7. Eating, dressing, bathing, or using the toilet | Limited for more than 3 months (1) | Limited for 3 months or less (2) | Not limited at all (3) | |||||
| 8. How much bodily pain have you had during the past 4 weeks: | None (1) | Very mild (2) | Mild (3) | Moderate (4) | Severe (5) | Very severe (6) | ||
| 9. Does your health keep you from working at a job, doing work around the house, or going to school? | Limited for more than 3 months (1) | Limited for 3 months or less (2) | Not limited at all (3) | |||||
| 10. Have you been unable to do certain kinds or amounts of work, housework, or schoolwork because of your health? | Limited for more than 3 months (1) | Limited for 3 months or less (2) | Not limited at all (3) | |||||
|
For each of the following questions, please select the answer that comes closest to the way you have been feeling during the past month. |
||||||||
| 11. How much of the time, during the past month, has your health limited your social activities (like visiting with friends or close relatives)? | All of the time (1) | Most of the time (2) | A good bit of time (3) | Some of the time (4) | A little of the time (5) | None of the time (6) | ||
| 12. How much of the time, during the past month, have you been a very nervous person? | All of the time (1) | Most of the time (2) | A good bit of time (3) | Some of the time (4) | A little of the time (5) | None of the time (6) | ||
| 13. During the past month, how much of the time have you felt calm and peaceful? | All of the time (6) | Most of the time (5) | A good bit of time (4) | Some of the time (3) | A little of the time (2) | None of the time (1) | ||
| 14. How much of the time, during the past month, have you felt downhearted and blue? | All of the time (1) | Most of the time (2) | A good bit of time (3) | Some of the time (4) | A little of the time (5) | None of the time (6) | ||
| 15. During the past month, how much of the time have you been a happy person? | All of the time (6) | Most of the time (5) | A good bit of time (4) | Some of the time (3) | A little of the time (2) | None of the time (1) | ||
| 16. How often, during the past month, have you felt so down in the dumps that nothing could cheer you up? | All of the time (1) | Most of the time (2) | A good bit of time (3) | Some of the time (4) | A little of the time (5) | None of the time (6) | ||
| Please select the answer that best describes whether each of the following statements is true or false for you. | |||||
| 17. I am somewhat ill | Definitely true (1) | Mostly true (2) | Not sure (3) | Mostly false (4) | Definitely false (5) |
| 18. I am as healthy as anybody I know | Definitely true (5) | Mostly true (4) | Not sure (3) | Mostly false (2) | Definitely false (1) |
| 19. My health is excellent | Definitely true (5) | Mostly true (4) | Not sure (3) | Mostly false (2) | Definitely false (1) |
| 20. I have been feeling bad lately | Definitely true (1) | Mostly true (2) | Not sure (3) | Mostly false (4) | Definitely false (5) |
The SF-20 is calculated by first assigning a client’s points to the answers for questions 1-20. Each question corresponds to a cluster, and each cluster has a maximum number of points.
| Cluster | Questions | Maximum points |
| Physical functioning | 2–7 | 18 |
| Role functioning | 9–10 | 6 |
| Social functioning | 11 | 6 |
| Mental health | 12–16 | 30 |
| Health perceptions | 1, 17–20 | 25 |
| Pain | 8 | 6 |
To calculate the score for a cluster, the client’s points are converted to a percentage with the following formula and rounded to a full number: (Client's score for cluster maximum) 100.
For all clusters except pain, percentage scores are represented from 0% to 100% (worst to best). For pain, percentage scores are represented from 0% to 100% (best to worst).
Sources
- Stewart, A. L., Hays, R. D., & Ware, J. E.. (1988). The MOS short-form general health survey: reliability and validity in a patient population. Medical Care, 26(7), 724-735.
- Stewart, A. L. & Berry, S. D. (1989). Functional status and well-being. Journal of the American Medical Association, 262, 907-913.
- Carver, D. J., Chapman, C. A., Thomas, V. S., Stadnyk, K. J., & Rockwood, K. (1999). Validity and reliability of the Medical Outcomes Study Short Form-20 questionnaire as a measure of quality of life in elderly people living at home. Age and Ageing, 28(2), 169-174.
FS
The Flourishing Study, or FS, is a tool designed to measure self-perceived success. It includes the following:
|
On a scale from 1 to 7, indicate your agreement with each item. |
|||||||
| 1. I lead a purposeful and meaningful life | 1 (Strongly disagree) | 2 (Disagree) | 3 (Slightly disagree) |
4 (Neither agree or disagree) |
5 (Slightly agree) | 6 (Agree) | 7 (Strongly agree) |
| 2. My social relationships are supportive and rewarding | 1 (Strongly disagree) | 2 (Disagree) | 3 (Slightly disagree) | 4 (Neither agree or disagree) | 5 (Slightly agree) | 6 (Agree) | 7 (Strongly agree) |
| 3. I am engaged and interested in my daily activities | 1 (Strongly disagree) | 2 (Disagree) | 3 (Slightly disagree) | 4 (Neither agree or disagree) | 5 (Slightly agree) | 6 (Agree) | 7 (Strongly agree) |
| 4. I actively contribute to the happiness and well-being of others | 1 (Strongly disagree) | 2 (Disagree) | 3 (Slightly disagree) | 4 (Neither agree or disagree) | 5 (Slightly agree) | 6 (Agree) | 7 (Strongly agree) |
| 5. I am competent and capable in the activities that are important to me | 1 (Strongly disagree) | 2 (Disagree) | 3 (Slightly disagree) | 4 (Neither agree or disagree) | 5 (Slightly agree) | 6 (Agree) | 7 (Strongly agree) |
| 6. I am a good person and live a good life | 1 (Strongly disagree) | 2 (Disagree) | 3 (Slightly disagree) | 4 (Neither agree or disagree) | 5 (Slightly agree) | 6 (Agree) | 7 (Strongly agree) |
| 7. I am optimistic about my future | 1 (Strongly disagree) | 2 (Disagree) | 3 (Slightly disagree) | 4 (Neither agree or disagree) | 5 (Slightly agree) | 6 (Agree) | 7 (Strongly agree) |
| 8. People respect me | 1 (Strongly disagree) | 2 (Disagree) | 3 (Slightly disagree) | 4 (Neither agree or disagree) | 5 (Slightly agree) | 6 (Agree) | 7 (Strongly agree) |
The FS is calculated by assigning a score of 1, 2, 3, 4, 5, 6, or 7 to the answers to questions 1-8, and the total score ranges from 8 to 56.
Higher scores are indicative of more psychological resources and strengths.
Source
- Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D., Oishi, S., & Biswas-Diener, R. (2009). New measures of well-being: Flourishing and positive and negative feelings. Social Indicators Research, 39, 247-266.
ARM-5
The Agnew Relationship Measure – 5, or ARM-5, is a tool designed to measure therapeutic alliance. It includes the following:
| Thinking about today’s or the most recent meeting, please indicate how strongly you agree or disagree with each statement. | |||||||
| 1. My therapist is supportive | Strongly disagree (1) | Disagree (2) | Slightly disagree (3) | Neutral (4) | Slightly agree (5) | Agree (6) | Strongly agree(7) |
| 2. My therapist and I agree about how to work together | Strongly disagree (1) | Disagree (2) | Slightly disagree (3) | Neutral (4) | Slightly agree (5) | Agree (6) | Strongly agree (7) |
|
3. My therapist and I have difficulty working jointly as a partnership |
Strongly disagree (7) | Disagree (6) | Slightly disagree (5) | Neutral (4) | Slightly agree (3) | Agree (2) | Strongly agree(1) |
| 4. I have confidence in my therapist and their techniques | Strongly disagree (1) | Disagree (2) | Slightly disagree (3) | Neutral (4) | Slightly agree (5) | Agree (6) | Strongly agree (7) |
| 5. My therapist is confident in him/herself and his/her techniques | Strongly disagree (1) | Disagree (2) | Slightly disagree (3) | Neutral (4) | Slightly agree (5) | Agree (6) | Strongly agree(7) |
The ARM-5 is calculated by assigning a score of 1, 2, 3, 4, 5, 6, or 7 to the answers to questions 1-5, and the total score ranges from 5 to 35.
Higher scores are indicative of a stronger, more positive alliance between client and therapist.
Source
- Agnew-Davies, R., Stiles, W. B., Hardy, G. E., Barkham, M., & Shapiro, D. A. (1998). Alliance structure assessed by the Agnew Relationship Measure (ARM). British Journal of Clinical Psychology, 37(2), 155–172.
DASS-21
The Depression Anxiety Stress Scales, or DASS-21, is a tool designed to measure the negative emotional states of depression, anxiety, and stress. It includes the following:
| Please read each statement and select the answer that indicates how much the statement applied to you over the past week. There are no right or wrong answers. Do not spend too much time on any statement. | ||||
| 1. I found it hard to wind down | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 2. I was aware of dryness of my mouth | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 3. I couldn’t seem to experience any positive feeling at all | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 4. I experienced breathing difficulty (eg, excessively rapid breathing, breathlessness in the absence of physical exertion) | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 5. I found it difficult to work up the initiative to do things | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 6. I tended to over-react to situations | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 7. I experienced trembling (eg, in the hands) | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 8. I felt that I was using a lot of nervous energy | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 9. I was worried about situations in which I might panic and make a fool of myself | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 10. I felt that I had nothing to look forward to | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 11. I found myself getting agitated | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 12. I found it difficult to relax | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 13. I felt down-hearted and blue | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 14. I was intolerant of anything that kept me from getting on with what I was doing | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 15. I felt I was close to panic | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 16. I was unable to become enthusiastic about anything | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 17. I felt I wasn’t worth much as a person | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 18. I felt that I was rather touchy | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 19. I was aware of the action of my heart in the absence of physical exertion (eg, sense of heart rate increase, heart missing a beat) | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 20. I felt scared without any good reason | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
| 21. I felt that life was meaningless | Did not apply to me at all (0) | Applied to me to some degree, or some of the time (1) | Applied to me to a considerable degree or a good part of time (2) | Applied to me very much or most of the time (3) |
The DASS-21 is calculated by first assigning a score of 0, 1, 2, or 3 to the answers for questions 1-21. Each question corresponds to a cluster:
- Depression (questions 3, 5, 10, 13, 16, 17, 21)
- Anxiety (questions 2, 4, 7, 9, 15, 19, 20)
- Stress (questions 1, 6, 8, 11, 12, 14, 18)
The total score for each cluster is then multiplied by two. Each final score will range from 0 to 42.
To interpret this for each cluster, see the tables below:
Depression
| Score | Severity |
| 0 - 9 | Normal depression |
| 10 - 12 | Mild depression |
| 13 - 20 | Moderate depression |
| 21 - 27 | Severe depression |
| 28 - 42 | Extremely severe depression |
Anxiety
| Score | Severity |
| 0 - 6 | Normal anxiety |
| 7 - 9 | Mild anxiety |
| 10 - 14 | Moderate anxiety |
| 15 - 19 | Severe anxiety |
| 20 - 42 | Extremely severe anxiety |
Stress
| Score | Severity |
| 0 - 10 | Normal stress |
| 11 - 18 | Mild stress |
| 19 - 26 | Moderate stress |
| 27 - 34 | Severe stress |
| 35 - 42 | Extremely severe stress |
Sources
- Lovibond, S. H., & Lovibond, P. F. (1995). Depression Anxiety Stress Scales (DASS--21, DASS--42) [Database record]. APA PsycTests. https://doi.org/10.1037/t01004-000
- Henry, J. D., & Crawford, J. R. (2005). The short‐form version of the Depression Anxiety Stress Scales (DASS‐21): Construct validity and normative data in a large non‐clinical sample. British Journal of Clinical Psychology, 44(2), 227-239.
C-SSRS
The Columbia Suicide Severity Rating Scale, or C-SSRS, is a tool designed to determine risk of suicide. It includes the following:
| Since last visit, or in the past month (if first visit): | ||
| 1. Have you wished you were dead or wished you could go to sleep and not wake up? | Yes | No |
| 2. Have you actually had any thoughts of killing yourself? | Yes | No |
| If you answered No to question 2, skip directly to question 6 | ||
|
3. Have you thought about how you might do this? (For example, “I thought about taking an overdose but I never worked out the details about when, where, and how I would do that and I would never act on these thoughts.”) |
Yes | No |
|
4. Have you had any intention of acting on these thoughts of killing yourself, as opposed to you have the thoughts, but you definitely would not act on them? (For example, “I had the thought of killing myself by taking an overdose and am not sure whether I would do it or not.”) |
Yes | No |
|
5. Have you started to work out, or actually worked out, the specific details of how to kill yourself and did you actually intend to carry out the details of your plan? (For example, “I am planning to take 3 bottles of my sleep medication this Saturday when no one is around to stop me.”) |
Yes | No |
|
6. Have you ever done anything, started to do anything, or prepared to do anything to end your life? (For example: Took pills, tried to shoot yourself, cut yourself, tried to hang yourself, took out pills but didn’t swallow any, held a gun but changed your mind about hurting yourself or it was grabbed from your hand, went to the roof to jump but didn’t, collected pills, obtained a gun, gave away valuables, wrote a will or suicide note; etc.) |
Yes | No |
The C-SSRS identifies suicide risk based on whether Yes was selected for the following questions:
| Questions | Severity |
| 1, 2, or no Yes answers | Low risk of suicide |
| 3 | Moderate risk of suicide |
| 4, 5, or 6 | High risk of suicide |
Important: A client’s severity risk will be indicated at the top of the page when you’re viewing their results.
Sources
- Posner, K., Brown, G.K., Stanley, B., Brent, D.A., Yeshiva, K.V., Oquendo, M.A., Currier, G.W., Melvin, G., Greenhill, L., Shen, S., & Mann, J.J., (2011). The Columbia‐Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168(12), 1266‐ 1277.
- Posner, K. (n.d.). Columbia-Suicide Severity Rating Scale (C-SSRS). Columbia University Medical Center; Center for Suicide Risk Assessment.
ASRS-v1.1
The Adult ADHD Self-Report Scale Symptom Checklist, or ASRS-v1.1, is a tool designed to screen for attention deficit/hyperactivity disorder (ADHD) in adults. It includes the following:
Part A
| 1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done? | Never (0) | Rarely (0) | Sometimes (1) | Often (1) | Very Often (1) |
| 2. How often do you have difficulty getting things in order when you have to do a task that requires organization? | Never (0) | Rarely (0) | Sometimes (1) | Often (1) | Very Often (1) |
| 3. How often do you have problems remembering appointments or obligations? | Never (0) | Rarely (0) | Sometimes (1) | Often (1) | Very Often (1) |
| 4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 6. How often do you feel overly active and compelled to do things, like you were driven by a motor? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
Part B
| 7. How often do you make careless mistakes when you have to work on a boring or difficult project? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 8. How often do you have difficulty keeping your attention when you are doing boring or repetitive work? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 9. How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly? | Never (0) | Rarely (0) | Sometimes (1) | Often (1) | Very Often (1) |
| 10. How often do you misplace or have difficulty finding things at home or at work? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 11. How often are you distracted by activity or noise around you? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 12. How often do you leave your seat in meetings or other situations in which you are expected to remain seated? | Never (0) | Rarely (0) | Sometimes (1) | Often (1) | Very Often (1) |
| 13. How often do you feel restless or fidgety? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 14. How often do you have difficulty unwinding and relaxing when you have time to yourself? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 15. How often do you find yourself talking too much when you are in social situations? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 16. When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves? | Never (0) | Rarely (0) | Sometimes (1) | Often (1) | Very Often (1) |
| 17. How often do you have difficulty waiting your turn in situations when turn taking is required? | Never (0) | Rarely (0) | Sometimes (0) | Often (1) | Very Often (1) |
| 18. How often do you interrupt others when they are busy? | Never (0) | Rarely (0) | Sometimes (1) | Often (1) | Very Often (1) |
The ASRS-v1.1 is calculated by assigning a score of 0 or 1 to the answers to questions 1-18. Each question corresponds to a cluster:
- Part A (questions 1-6)
- Part B (question 7-18)
Only Part A determines the clinical threshold, while Part B and the overall score indicate severity and range of symptoms over time. To interpret the clinical threshold for Part A, see the table below:
| Score | Severity |
| 0 - 3 | No or subclinical ADHD symptoms |
| 4 - 6 | Symptoms are highly consistent with ADHD in adults |
Source
Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., Howes, M. J., Jin, R., Secnik, K., Spencer, T., Ustun, T. B., & Walters, E. E. (2005). The World Health Organization Adult ADHD Self-Report Scale (ASRS): A short screening scale for use in the general population. Psychological Medicine, 35(2), 245–256.
CDC HRQOL- 4 Plus 1
The Health Related Quality of Life, or CDC HRQOL- 4 Plus 1, is a tool designed to measure an individual’s perception of their own physical and mental health over 30 days. It includes the following:
| 1. Would you say that in general your health is? | Excellent | Very good | Good | Fair | Poor |
| 2. Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good? | 0-30 | ||||
| 3. Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good? | 0-30 | ||||
| 4. During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation? | 0-30 | ||||
| 5. How many days in the past 30 days did you seek care from a healthcare provider? | 0-30 | ||||
Note: For questions 2-5, clients can choose between 0-30 using a dropdown menu.
Out of the past 30 days, the CDC HRQOL- 4 Plus 1 calculates how many days fall into the following categories:
- Physically unhealthy days (question 2)
- Mentally unhealthy days (question 3)
- Days limited by health (question 4)
- Days in healthcare (question 5)
The following formula is used to determine the overall number of healthy days: (Days for question 2) + (Days for question 3) - 30.
If the total is negative, the absolute value equals the number of healthy days. For example, if the total is -5, the client has had 5 healthy days within the past 30 days.
If the total is positive, the client has had 0 healthy days.
Source
- National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health
WHODAS 2.0
The WHO Disability Assessment Schedule 2.0, or WHODAS 2.0, is a tool designed to measure health and disability. It includes the following:
| In the past 30 days, how much difficulty did you have in: | |||||
| 1. Standing for long periods such as 30 minutes? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 2. Taking care of your household responsibilities? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 3. Learning a new task, for example, learning how to get to a new place? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 4. Joining in community activities (for example, festivities, religious, or other activities) in the same way as everyone else can? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 5. How much have you been emotionally affected by your health problems? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 6. Concentrating on doing something for ten minutes? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 7. Walking a long distance such as half a mile? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 8. Washing your whole body? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 9. Getting dressed? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 10. Dealing with people you do not know? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 11. Maintaining a friendship? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 12. Your day-to-day work/school? | None (1) | Mild (2) | Moderate (3) | Severe (4) | Extreme or cannot do (5) |
| 13. Overall, in the past 30 days, how many days were these difficulties present? | 0-30 | ||||
| 14. In the past 30 days, for how many dates were you totally unable to carry out your usual activities or work because of any health condition? | 0-30 | ||||
| 15. In the past 30 days, not counting the days that you were totally unable, for how many days did you cut back or reduce your usual activities or work because of any health condition? | 0-30 | ||||
Note: For questions 13-15, clients can choose between 0-30 using a dropdown menu.
The WHODAS 2.0 is calculated by first assigning a score of 1, 2, 3, 4, or 5 to the answers for questions 1-12. The total score is divided by 12, then rounded to the nearest tenth.
| Score | Disability |
| 0-1.9 | None |
| 2-2.9 | Mild |
| 3-3.9 | Moderate |
| 4-4.9 | Severe |
| 5 | Extreme |
Sources
- Üstün, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., Saxena, S., von Korff, M. & Pull, C. (2010). Developing the World Health Organization disability assessment schedule 2.0. Bulletin of the World Health Organization, 88, 815-823.
- Bovin, M. J., Meyer, E. C., Kimbrel, N. A., Kleiman, S. E., Green, J. D., Morissette, S. B., & Marx, B. P. (2019). Using the World Health Organization Disability Assessment Schedule 2.0 to assess disability in veterans with posttraumatic stress disorder. PloS One, 14(8), e0220806. https://doi.org/10.1371/journal.pone.0220806
SP-GAM
The SimplePractice Goal Attainment Measure, or SP-GAM, is a tool designed to evaluate a client’s perception of their progress toward their primary treatment goal. This is a measure created by our team at SimplePractice to assist with monitoring goal attainment over time, within the context of your client’s unique background.
It includes the following:
| On a rating scale from 0 to 100: | |||||
|
1. How much progress have you made towards your primary goal for entering treatment? 0 (none at all) to 100 (complete) |
0-100 | ||||
|
2. How motivated are you to continue working towards your primary goal for entering treatment? 0 (none at all) to 100 (complete) |
0-100 | ||||
|
3. How confident are you that you will achieve your primary treatment goal? 0 (none at all) to 100 (complete) |
0-100 | ||||
|
4. How confident are you that you will achieve your primary treatment goal in the next month? 0 (none at all) to 100 (complete) |
0-100 | ||||
|
5. How helpful has treatment been in supporting your ability to reach your primary goal? 0 (none at all) to 100 (complete) |
0-100 | ||||
Note: For questions 1-5, clients can choose between 0-100 using a dropdown menu.
Each question corresponds to a cluster:
- Progress (question 1)
- Motivation (question 2)
- Long-term confidence (question 3)
- Short-term confidence (question 4)
- Treatment impact (question 5)
Higher scores represent more progress towards goals.
Source
- SimplePractice LLC 2024
OCI-R
The Obsessive-Compulsive Inventory, or OCI-R, is a tool designed to measure symptoms of obsessive-compulsive disorder (OCD). It includes the following:
| Select the answer that best describes how much that experience has distressed or bothered you during the past month. | |||||
| 1. I have saved up so many things that they get in the way. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 2. I check things more often than necessary. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 3. I get upset if objects are not arranged properly. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 4. I feel compelled to count while I am doing things. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 5. I find it difficult to touch an object when I know it has been touched by strangers or certain people. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 6. I find it difficult to control my own thoughts. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 7. I collect things I don’t need. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 8. I repeatedly check doors, windows, drawers, etc. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 9. I get upset if others change the way I have arranged things. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 10. I feel I have to repeat certain numbers. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 11. I sometimes have to wash or clean myself simply because I feel contaminated. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 12. I am upset by unpleasant thoughts that come into my mind against my will. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 13. I avoid throwing things away because I am afraid I might need them later. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 14. I repeatedly check gas and water taps and light switches after turning them off. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 15. I need things to be arranged in a particular way. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 16. I feel that there are good and bad numbers. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 17. I wash my hands more often and longer than necessary. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
| 18. I frequently get nasty thoughts and have difficulty in getting rid of them. | Not at all (0) | A little (1) | Moderately (2) | A lot (3) | Extremely (4) |
The OCI-R is calculated by assigning a score of 0, 1, 2, 3, or 4 to the answers for questions 1-18. The total score ranges from 0 to 72.
| Score | Interpretation |
| 0 - 20 | Generally does not indicate a likely presence of OCD |
| 21 - 72 | Generally indicates a likely presence of OCD |
Source
- Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P. M. (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological assessment, 14(4), 485–496.