| The following anxiety self test has been developed to assist adults in determining if they may be experiencing symptoms related to generalized anxiety disorder (GAD). This is only a preliminary questionaire and should not be used to diagnose or treat any condition, disorder or disease. |
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| 1. Have you experienced an unusually excessive level of worry about various aspects of life lately? |
| Yes |
| No |
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| 2. Do you find yourself feeling overly restless or edgy? |
| Yes |
| No |
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| 3. Lately, do you find yourself more easily angered or irritated by events that would normally be minimally annoying? |
| Yes |
| No |
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| 4. Even when you’re aware that the worry is needless, do you still find yourself feeling anxious? |
| Yes |
| No |
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| 5. Do you find it unusually difficult to concentrate or stay focused? |
| Yes |
| No |
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| 6. Do you find yourself getting tired easily, even after activities that are minimally taxing? |
| Yes |
| No |
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| 7. Do you use cocaine, alcohol, amphetamines, or marijuana on a regular basis? |
| Yes |
| No |
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| 8. Have you been experiencing sleep problems lately such as difficulty falling asleep, difficulty staying asleep, tossing and turning, or waking feeling unrefreshed? |
| Yes |
| No |
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| 9. Have you been getting into arguments often with family and friends? |
| Yes |
| No |
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| 10. Does your excessive worry revolve around any of the following specifically: gaining weight, having a physical disease, being separated from a loved one, or being involved in social engagements? |
| Yes |
| No |
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| 11. Do you experience any number of the following to the level that it impairs your ability to function or perform regular daily activities: restlessness, irritability, sleep difficulty, fatigue, trouble concentrating? |
| Yes |
| No |
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| 12. Do you feel unable to relax, even when nothing really stressful is happening? |
| Yes |
| No |
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| 13. Have you also been experiencing feelings of sadness or emptiness alongside the tension and worry? |
| Yes |
| No |
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| 14. Have you been experiencing physical symptoms of tension such as chronic upset stomach, agitation, or inability to sit still? |
| Yes |
| No |
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| 15. Has your excessive worry stayed relatively constant for the last 6 months or longer? |
| Yes |
| No |
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