LONG MONTH ‘Ass / Wk / Sess: HAI Each question is this section consists of a group of four statements. Please read each group of statements carefully and then select the one which best describes your feelings, OVER THE PAST SIX the statement by ringing the letter next to you think that statement (a) i correct, ring statement (a); it may be that more than one statement appli which case, please ring any that are applicable. 1 Ido not worry about my health |! occasionally worry about my health | spend much of my time worrying about my health. I spend most of my time worrying about my health. aece | notice aches/pains less than most other people (of my age) | notice aches/pains as much as most other people (of my age), | notice aches/pains more than most other people (of my age). | am aware of aches/pains in my body all the time. aece As a rule | am not aware of bodily sensations or changes. ‘Sometimes | am aware of bodily sensations or changes. Jam often aware of bodily sensations or changes. 1am constantly aware of bodily sensations or changes. eege When | have an unexplained bodily sensation or change | rarely worry about it ‘When | have an unexplained bodily sensation or change | sometimes worry about it. When | have an unexplained bodily sensation or change | often worry about it. When | have an unexplained bodily sensation or change | always worry about it eege Resisting thoughts of illness is never a problem. Most of the time | can resist thoughts of illness. | try to resist thoughts of illness but am often unable to do so. Thoughts of illness are so strong that I no longer even try to resist them. aege I never worry about dying J occasionally worry about dying. {often worry about dying I worry about dying most of the time. aege 7. a. When | have an unexplained bodily sensation or change, | rarely think that it is a sign of b When have an unexplained bodily sensation or change, | sometimes think that itis a sign of c. _ When have an unexplained bodily sensation or change, late thnk thats sign of 4 nen Ihave an unexplained bodily sensation or change, | always think that it is a sign of illness. As a rule | am not afraid that | have a serious illness. lam sometimes afraid that | have a serious illness. am often afraid that | have a serious illness. | am always afraid that | have a serious illness, aece | do not have images (mental pictures) of myself being ill. | occasionally have images of myself being il. | frequently have images of myself being ill | constantly have images of myself being il aege10, " 12, 13. 14. 15, 16. 17. 18, 19, 20. 2 aece aegp afpgm ance ange ange sees aogm aooe a aece Itusually feels extremely unlikely that | will develop a serious illness in the near future. it usually feels unlikely that | will develop a serious illness in the near future It usually feels as though there is some likelihood that | will develop a serious illness in the near future. It usually feels likely that | will develop a serious illness in the near future. If notice an unexplained bodily sensation or change | don't check to see how it develops, If I notice an unexplained bodily sensation or change | check it occasionally to see how itis. developing. If | notice an unexplained bodily sensation or change | check it frequently to see how itis developing, If | notice an unexplained bodily sensation or change | constantly check on it The idea that | have a serious illness is senseless, The idea that | have a serious illness might be sensible. The idea that I have a serious illness is probably sensible. The idea that | have a serious illness is realistic. | do not avoid situations which trigger thoughts of death or dying. | sometimes avoid situations which trigger thoughts of death or dying | often avoid situations which trigger thoughts of death or dying | always avoid situations which trigger thoughts of death or dying, If notice an unexplained bodily sensation | ignore it. If | notice an unexplained bodily sensation | focus on it from time to time. If | notice an unexplained bodily sensation | focus on it often. If | notice an unexplained bodily sensation | constantly focus on it. don't usually examine my body. often examine my body examine my body daily. J examine my body constantly. Ido not have any difficulty taking my mind off thoughts about my health. | sometimes have difficulty taking my mind off thoughts about my health | often have difficulty in taking my mind off thoughts about my health Nothing can take my mind off thoughts about my health, | am lastingly relieved if my doctor tells me there is nothing wrong. | am initially relieved but the worries sometimes return later. | am initially relieved but the worries always return later. | am not relieved if my doctor tells me there is nothing wrong If | hear about an illness | never think | have it myself. If | hear about an illness | sometimes think I have it myself. If | hear about an illness | often think | have it myself. If hear about an illness | always think | have it myself. If | notice an unexplained bodily sensation or change | rarely try to find out the cause. If | notice an unexplained bodily sensation or change | sometimes try to find out the cause. If | notice an unexplained bodily sensation or change | often try to find out the cause. If | notice an unexplained bodily sensation or change | always try to find out the cause. My health worries do not interfere with my life. Occasionally my health worries interfere with my life. Often health worries interfere with my life Tam unable to do anything because of my health worries. I never believe that | am going to die soon. I sometimes believe that | am going to die soon. | often believe that | am going to die soon. | constantly believe that | am going to die soon.22. 23. 24. 25. 26. 27. 28. 29. 30. 34 32. 33. 34. eegm acm ange aege arcs apse eaege aoc ange eege apce aoge aes | am never afraid of visiting my doctor because of my health worries. | am sometimes afraid of visiting my doctor because of my health worries, | am often afraid of visiting my doctor because of my health worries. | am too afraid to visit my doctor because of my health worries Worries about my health do not stop me thinking about other things. Worries about my health sometimes stop me thinking about other things. Worries about my health often stop me thinking of other things. | am so worried about my health that | can think of nothing else. If Inotice an unexplained bodily sensation | never feel a need to distract myself from it If | notice an unexplained bodily sensation | sometimes try to distract myself from it. If notice an unexplained bodily sensation | often try to distract myself from it. If | notice an unexplained bodily sensation | always try to distract myself from it The idea that | have a serious illness never seems sensible The idea that | have a serious illness sometimes seems sensible. The idea that | have a serious illness often seems sensible The idea that | have a serious illness always seems sensible, My previous illnesses were properly treated. My previous illnesses could have been slightly better treated My previous illnesses could have been much better treated My previous illnesses were seriously mismanaged. If | have a bodily sensation or change I rarely wonder what it means. if Ihave a bodily sensation or change | often wonder what it means. If | have a bodily sensation or change | always wonder what it means, If | have a bodily sensation or change I must know what it means. | do not avoid situations where illness is prominent. | sometimes avoid situations where illness is prominent. | often avoid situations where iliness is prominent. | always avoid situations where illness is prominent. | usually feel at very low risk for developing a serious illness, | usually feel at fairly low risk for developing a serious illness, | usually feel at moderate risk for developing a serious illness. | usually feel at high risk for developing a serious illness. | rarely have images of myself dying or dead. | occasionally have images of myself dying or dead | frequently have images of myself dying or dead. | constantly have images of myseif dying or dead. If Inotice an unexplained bodily sensation | never mention it to others. if | notice an unexplained bodily sensation | sometimes mention it to others. if | notice an unexplained bodily sensation | often mention it to others. If | notice an unexplained bodily sensation | always mention it to others. ‘As a rule, | do not think about what it would be like if! were seriously ill. I sometimes think about what it would be like if | were seriously ill | frequently think about what it would be like if | were seriously ill. I constantly think about what it would be like if | were seriously ill | do not usually feel at all vulnerable to serious illness. usually feel slightly vulnerable to serious illness, | usually feel moderately vulnerable to serious illness, usually fee! extremely vulnerable to serious illness. If I notice an unexplained bodily sensation or change | never try to reassure myself about it If | notice an unexplained bodily sensation or change | sometimes try to reassure myself about it If | notice an unexplained bodily sensation or change I often try to reassure myself about it If | notice an unexplained bodily sensation or change | always try to reassure myself about it.36. 36. 37. 38. 39. 40. a 42. 43. 45, 46. aecm a9 ge Boge aegD apse aegw ance ance a oc®e aece eoge | never think | have a serious illness. | sometimes think | have a serious illness. | often think | have @ serious illness | usually think that | am seriously il It usually feels extremely unlikely that | will become ill (in any way) in the next few weeks. It usually feels unlikely that | will become ill (in any way) in the next few weeks. It usually feels as though there is some possibility that | will become ll (in any way) in the next few weeks. It usually feels likely that I will become ill (in any way) in the next few weeks. As a rule | am not afraid of developing a serious illness. am sometimes afraid of developing a serious illness. | am afraid of developing a serious illness most of the time. | am afraid of developing a serious illness all the time. Itis extremely unlikely that | have an undiagnosed serious illness. itis fairly unlikely that | have an undiagnosed serious illness. itis fairly likely | have an undiagnosed serious illness. Itis very likely | have an undiagnosed serious iliness. If | think about developing a serious illness | fee! a little scared. If | think about developing a serious illness | fee! moderately scared If think about developing a serious illness | feel very scared If think about developing a serious illness | feel terrified. When I have a pain, | rarely think that itis a sign of illness When | have a pain, | sometimes think that itis a sign of iliness. When | have a pain, | often think that itis a sign of illness. When | have a pain, | always think that itis a sign of illness. It usually feels extremely unlikely that | will die soon. It usually feels as if there is a fair chance that | will die soon. It usually feels as though | will probably die soon. It usually feels as though | am going to die soon. If | notice an unexplained bodily sensation | never do anything to try to get rid of it. If notice an unexplained bodily sensation | sometimes try to get rid of it. If notice an unexplained bodily sensation | often try to get rid of it. If | notice an unexplained bodily sensation | always try to get rid of it If notice an unexplained bodily sensation | don't find it dificult to think about other things. If notice an unexplained bodily sensation | sometimes find it difficult to think about other things. If | notice an unexplained bodily sensation | often find it difficult to think about other things. If | notice an unexplained bodily sensation | always find it dificult to think about other things If | hear about a certain illness it never causes me to worry about other illnesses. If | hear about a certain illness it sometimes causes me to worry about other illnesses, If hear about a certain illness it often causes me worry about other illnesses. If | hear about a certain illness it always causes me to worry about other illnesses. My family/friends would say | do not worry enough about my health My family/friends would say | have a normal attitude to my health. My family/friends would say | worry too much about my health. My family/friends would say | am a hypochondriac. My GP would say I do not worry enough about my health. My GP would say | have a normal attitude to my health. My GP would say I worry too much about my health. My GP would say | am a hypochondriac.47. | think | worry too little about my health. | think | have a normal attitude to my health. | think | worry too much about my health. | think | am a hypochondriac.For the following questions, please think about what it might be like if you had a seriou: type which particularly concerns you (such as heart disease, cancer, multiple sclerosis and so on). Obviously you cannot know for definite what it would be like; please give your best estimate of what you think might happen, basing your estimate on what you know about yourself and serious illness in general. 48. a. _ If |hada serious illness there is a good chance that | would still be able to have a reasonable quality of life b. If had a serious illness there is a small chance that | would stil be able to have a reasonable quality of life If had a serious illness there is only a very small chance that | still would be able to have a reasonable quality of life. d. If Ihad a serious illness there is no chance that | would stil be able to have a reasonable quality of life 49 If | developed a serious illness there is a small chance that it would be very painful If | developed a serious illness there is a moderate chance that it would be very painful If | developed a serious illness there is an extremely high chance that it would be very painful If | developed a serious illness it would definitely be very painful aoce 50. If | developed a serious illness there is a small chance that it would be fatal If | developed a serious illness there is a moderate chance that it would be fatal If | developed a serious illness there is an extremely high chance that it would be fatal. If | developed a serious illness it would definitely be fatal. aece 51 2 If | developed a serious illness there is a small chance that it would involve prolonged suffering b. If developed a serious illness there is a moderate chance that it would involve prolonged suffering c. If developed a serious illness there is an extremely high chance that it would involve prolonged suffering. If | developed a serious illness it would definitely involve prolonged suffering 52. if Thad a serious illness | would still be able to enjoy things in my life quite a lot. if had a serious illness | would still be able to enjoy things in my life a little if | had a serious illness | would be almost completely unable to enjoy things in my life. If [had a serious illness | would be completely unable to enjoy life at all aoce 53. If | developed a serious illness there is a good chance that modern medicine would be able to cure me. b. If developed a serious illness there is a moderate chance that modem medicine would be able to cure me. ©. If developed a serious illness there is a very small chance that modern medicine would be able to cure me. 4. If developed a serious illness there is no chance that modern medicine would be able to cure me. 54. a. __If | developed a serious illness my family and friends would not act in a pitying way towards me (or it would not bother me if they did). b. If developed a serious illness my family and friends would act in a fairly pitying way towards me. If | developed a serious illness my family and friends would act in a very pitying way towards me. d. If developed a serious illness my family and friends would act in an exceedingly pitying way towards me. 55. If had a serious illness my belief in my own worth would not change. If Thad a serious illness my belief in my own worth would be slightly affected If had a serious iliness my belief in my own worth would be strongly affected If had a serious iliness my belief in my own worth would be destroyed. aece56. 87. 58. 59. 60. 61 62, 63, aege aocm a2 ose aogB aeee aoeD aose aege aege A serious illness would ruin some aspects of my life A serious illness would ruin many aspects of my life, A serious illness would ruin almost every aspect of my life. A serious illness would ruin every aspect of my life. If | developed a serious illness my family and friends would not reject me. If | developed a serious illness my family and friends might reject me. If | developed a serious illness my family and friends would probably reject me. If | developed a serious illness my family and friends would definitely reject me. If had a serious illness | would not feel that | had lost my dignity. If [had a serious illness | would feel that I had lost a little of my dignity. if [had a serious illness | would feel that I had lost quite a lot of my dignity. If [had a serious illness | would fee! that | had totally lost my dignity. | would not feel ashamed if | developed a serious illness. | would feel slightly ashamed if | developed a serious illness. | would feel moderately ashamed if | developed a serious illness, I would feel deeply ashamed if | developed a serious illness. If I developed a serious illness | would be able to tolerate loss of independence. If I developed a serious illness | would have some difficulty tolerating loss of independence. If | developed a serious illness | would have considerable difficulty tolerating loss of independence. If | developed a serious illness | would find loss of independence completely intolerable. If | developed a serious illness, my family would be able to cope without me. If | developed a serious illness, my family would have some problems coping without me. If | developed a serious illness, my family would have great difficulty coping without me. If | developed a serious illness, my family would be completely unable to cope without me, If | developed a serious illness my family and friends would care. If | developed a serious illness my family and friends would care to some extent. If I developed a serious illness my family and friends would not care very much. If I developed a serious illness my family and friends would not care at all If | developed a serious illness there are many people who would be able to support me. If | developed a serious illness there are several people who would be able to support me. If | developed a serious illness there are one or two people who would be able to support me. If | developed a serious illness there is no-one who would be able to support me. | would cope very well if | developed a serious illness. I would cope fairly well if l developed a serious illness, | would cope badly if | developed a serious iliness. I would be unable to cope if | developed a serious illness.‘As a rule, how much do you worry about the following conditions? Please tick the appropriate column. Not at all Heart trouble / attacks Less than most people ‘Same as most people More than most people All the time Strokes Cancer Multiple sclerosis AIDS Other How much do you worry about each of the following? Please tick the appropriate column. Notatall | Lessthan | Sameas | Morethan | Allthe most most most people people people Death of self Pain Death of relative Death of friend Being unable to look after yourself Going madChoose a number from the scale below to show how much you would avoid each of the situations listed below because of fear or other unpleasant feelings. Then write the number you chose in the space provided. 0. 1 2 a 4 5 6. oe Would not Slightly Definitely Markedly Always: avoid it avoid it avoid it avoid it avoid it 1. Consulting your family doctor...... 2. Visiting a friend in hospital. 3. Visiting a relative in hospital. 4. Going to a hospital for treatment. 5. Talking about illness 6. Reading about illness. 7. Visiting a hospital for other reasons (e.g. delivering a message).. 8 Watching TV programmes about illness. 8. Listening to radio programmes about illness. 10. Thinking about illness. Choose a number from the scale below which best describes how often you seek reassurance about your health, from each of the sources described below. Then write the number you have chosen in the space provided. 0. A, z 3. 4. 5. 6. 7. 8 Never Rarely Sometimes Often Daily 1. Friends. 2. Family. 3. Reading books. 4. Checking body for changes. 5. Family doctor. 6. Nurses. 7. Hospital outpatient clinic. 8. Hospital casualty. 9 Other (specify)