GDQ91 Client Questionaire mobile version

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Below is a list of symptoms. Please indentify how much distress you have experienced in relation to these symptoms or behaviours over the past two weeks. Give yourself a score between 0 and 9. For example, 0 = None, 3 = Some, 6 = Often, and 9 = Most.

(If you are completing this questionnanire in a public place it is advisable to delete your browsing history after completing this form. This questionaire is not designed as a replacement for an assessment with a trained practitioner. Results should be used for guidance only and do not represent a formal diagnosis.)

1. Feeling nervous

2. Racing or pounding heart

3. Distressing images or thoughts

4. Feeling a need to check and recheck what you do

5. Worrying about your health

6. Low mood

7. Attending a social event or avoiding a social event due to anxiety

8. Finding it hard to sit still

9. Feelings of things not being real

10. Experience of a strong startle response

11. Your mind going blank

12. Worry about aches or pains in your body

13. Lacking in energy

14. Being introduced to someone new or avoiding introductions

15. Feeling nervous when left alone

16. Fear of having a heart attack, losing your mind or having a stroke

17. Your body physically reacting when you are reminded of something from your past

18. Worrying about what you have or haven't done

19. Having thoughts that you are seriously ill

20. Lack of pleasure or interest in things

21. Talking to someone that you don't know very well

22. Feeling tense

23. Feeling sick

24. Avoiding situations that remind you of the past

25. Feeling a need to repeat actions to stop some thing happening

26. Feeling a need to examine your body for signs of illness

27. Poor concentration or ability to make decisions

28. Using public lavatories or avoidance of using public lavatories

29. Trouble relaxing

30. Feeling dizzy, unsteady or faint

31. Feeling distant or disconnected from others

32. Needing to arrange things in a specific order or pattern

33. Worrying that you may have heart disease

34. Lack of appetite or eating too much

35. Looking at people you don't know very well in the eyes or avoiding eye contact

36. Feeling anxious or on edge

37. Trembling or shaking

38. Irritable or angry outbursts

39. Unwanted thoughts entering your mind

40. Monitoring your body for signs of ill health

41. Thoughts of suicide

42. Concerns about how you are coming across to others

43. Easily irritated

44. Feeling an urge to escape

45. Reliving experiences from the past

46. Cleaning things to avoid contamination

47. Feeling an urge to read up about illnesses

48. A lack of sleep or excessive sleep

49. Performing an activity while being watched or avoiding being watched

50. Spells of terror and panic

51. Chest pain neck pain or headaches

52. Fitful sleep

53. Finding it difficult to throw things away

54. Thinking about needing to see a medical professional about your health

55. Feeling slowed down

56. Being noticed entering a room

57. Feeling as if something bad is going to happen

58. Tingling in hands or feet

59. Dreaming about the past

60. Feeling you will cause something bad to happen

61. Being pre-occupied about thoughts about your health

62. Loss of sexual interest

63. Saying what you think or keeping things to yourself due to anxiety

64. Not able to stop worrying

65. Problems concentrating

66. Avoiding talking about the past

67. Not able to concentrate for very long

68. Feeling that you are going to die very soon

69. Feelings of worthlessness

70. Eating or drinking in public or avoiding eating or drinking in public

71. Having to avoid certain places or things

72. Sweating

73. Difficulties going to sleep

74. Avoiding objects or things to keep safe

75. Worrying that you have cancer

76. Feelings of not being able to function

77. Talking to an authority figure or avoidance of authority figures

78. Pains in your heart or your chest

79. Feelings of helplessness

80. Difficulty remembering past distressing episodes

81. Thinking rituals, compulsion to run the same thoughts over and over in the mind

82. Images of self being ill

83. Feelings of hopelessness

84. Participating in a group activity or avoiding group activities

85. Feeling afraid in open places or streets

86. Fear of engaging in embarrassing behaviour

87. Experiencing a limited range of emotions

88. Rituals preventing you from carrying out daily living

89. Worrying that you may have an as yet unidentified disease

90. Body aching

91. Concerns about your appearance

Results

Your total self-report scores on 7 dimensions (anxiety, panic, social anxiety, depression, obsessional compulsive disorder (OCD), post trauma disorder (PTD) and health anxiety) are shown at the bottom of this webpage.

Scores are based on standard self-report questionanires used commonly at a clinical level to assess specifc conditions. Generally, a score

Below 30

Indicates this particular dimension is not significantly hampering your life.

Between 30 and 50

Indicates that symptoms on this area are having a noticeable impact on your life and you may consider completing some work on this area with your therapist.

Between 50 and 78

Is likely to mean that your symptoms are having a moderate impact on your life and you may benefit from completing some work on this area with your therapist.

Over 78

Indicates that your symptoms are having a severe impact on your life and you are almost certainly likely to need to complete work on this area with your therapist.

FINAL SCORES

Anxiety total

Panic total

Depression

Health Anxiety total

Social Anxiety total

PTD total

OCD total

GDQ91 Self-Assessment Instrument