Questions 1 - 8

The following statements describe thoughts, feelings, and experiences that people may have. Please indicate how well each statement describes you, during the past two weeks, from "not at all like me" (0) to "extremely like me" (4), by marking the correct number. Read each statement carefully, select only one answer per statement, and please do not skip any questions.
0 - Not at all like me1234 - Extremely like me
01234
I get sad or angry when I think of my family.
I am shy around others.
There are many things I am afraid of.
My heart races for no good reason.
I feel out of control when I eat.
I enjoy my classes.
I feel that my family loves me.
I feel disconnected from myself.

Questions 9 - 16

The following statements describe thoughts, feelings, and experiences that people may have. Please indicate how well each statement describes you, during the past two weeks, from "not at all like me" (0) to "extremely like me" (4), by marking the correct number. Read each statement carefully, select only one answer per statement, and please do not skip any questions.
0 - Not at all like me1234 - Extremely like me
01234
I don't enjoy being around people as much as I used to.
I feel isolated and alone.
My family gets on my nerves.
I lose touch with reality.
I think about food more than I would like to.
I am anxious that I might have a panic attack while in public.
I feel confident that I can succeed academically.
I become anxious when I have to speak in front of audiences.

Questions 17 - 26

The following statements describe thoughts, feelings, and experiences that people may have. Please indicate how well each statement describes you, during the past two weeks, from "not at all like me" (0) to "extremely like me" (4), by marking the correct number. Read each statement carefully, select only one answer per statement, and please do not skip any questions.
0 - Not at all like me1234 - Extremely like me
01234
I have sleep difficulties.
My thoughts are racing.
I am satisfied with my body shape.
I feel worthless.
My family is basically a happy one.
I am dissatisfied with my weight.
I feel helpless.
I use drugs more than I should.
I eat too much.
I drink alcohol frequently.