No Tension | Assessment

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

1. Little interest or pleasure in doing things?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

2. Feeling down, depressed, or hopeless?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

3. Feeling more irritated, grouchy, or angry than usual?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

4. Sleeping less than usual, but still have a lot of energy?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

5. Starting lots more projects than usual or doing more risky things than usual?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

6. Feeling nervous, anxious, frightened, worried, or on edge?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

7. Feeling panic or being frightened?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

8. Avoiding situations that make you anxious?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

9. Unexplained aches and pains (e.g., head, back, joints, abdomen, legs)?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

10. Feeling that your illnesses are not being taken seriously enough?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

11. Thoughts of actually hurting yourself?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

12. Hearing things other people couldn’t hear, such as voices even when no one was around?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

13. Feeling that someone could hear your thoughts, or that you could hear what another person was thinking?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

14. Problems with sleep that affected your sleep quality over all?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

15. Problems with memory (e.g., learning new information) or with location (e.g., finding your way home)?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

16. Unpleasant thoughts, urges, or images that repeatedly enter your mind?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

17. Feeling driven to perform certain behaviors or mental acts over and over again?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

18. Feeling detached or distant from yourself, your body, your physical surroundings, or your memories?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

19. Not knowing who you really are or what you want out of life?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

20. Not feeling close to other people or enjoying your relationships with them?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

21. Drinking at least 4 drinks of any kind of alcohol in a single day?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

22. Smoking any cigarettes, a cigar, or pipe, or using snuff or chewing tobacco?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)

DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure—Adult
During the past TWO (2) WEEKS, how much (or how often) have you been bothered by the following problems?

23. Using any of the following medicines ON YOUR OWN, that is, without a doctor’s prescription, in greater amounts or longer than prescribed [e.g., painkillers (like Vicodin), stimulants (like Ritalin or Adderall), sedatives or tranquilizers (like sleeping pills or Valium), or drugs like marijuana, cocaine or crack, club drugs (like ecstasy), hallucinogens (like LSD), heroin, inhalants or solvents (like glue), or methamphetamine (like speed)]?

not at all

slight Rare (less than a day or two)

mild several days

moderate (more than half the days)

severe (nearly every day)