MDS

Please read each of the following statements. Rate how often each one has been true
for you in the past two weeks by circling the response that fits best.

None or little of the time Some of the time Most of the time All of the time
1 2 3 4

During the past two weeks…

none or some of the most of the all of the

little of the time time time
time
1 2 3 4
1. I’ve been under constant
pressure 1 2 3 4

2. I’ve been numb

1 2 3 4

3. People don’t understand

what is going on with me 1 2 3 4

4. I’ve yelled at people or

things 1 2 3 4

5. I just can’t win

1 2 3 4

6. My body has been aching

1 2 3 4

7. I’ve failed a lot

1 2 3 4

8. I think about crying, but I

can’t cry 1 2 3 4

9. I am more stressed out

than usual 1 2 3 4

10. I’ve been inadequate

sexually 1 2 3 4

none or some of the most of the all of the

little of the time time time
 time
1 2 3 4
11. No one gives me a break
1 2 3 4

12. I’ve been keeping to

myself 1 2 3 4

13. I’ve been burned out

1 2 3 4

14. I have been drinking a lot

1 2 3 4

15. It has been easier to focus

on work or school than the 1 2 3 4
rest of my life

16. I’ve been inpatient

1 2 3 4

17. I haven’t felt anything

1 2 3 4

18. I’ve gotten so angry I hit

someone 1 2 3 4

19. I am down but it seems

best to keep it to myself 1 2 3 4

20. I’ve had unexplained aches

and pains 1 2 3 4

21. I’ve needed more sex than

usual to feel good 1 2 3 4

22. I’ve been irritable

1 2 3 4

23. Its one hassle after another

1 2 3 4

none or some of the most of the all of the

little of the time time time
time
1 2 3 4
24. I haven’t measured up
1 2 3 4

25. I don’t really care what

people think about me 1 2 3 4

26. I’ve had a short fuse

1 2 3 4

27. I’ve had lots of reasons to

cry, but I haven’t cried 1 2 3 4

28. I’ve gotten frequent

headaches 1 2 3 4

29. I keep hitting a wall

1 2 3 4

30. I don’t get sad, I get mad

1 2 3 4

31. I’ve been concerned about

my performance sexually 1 2 3 4

32. I don’t feel as confident

about my decisions 1 2 3 4

33. Alcohol or drugs have

helped me feel better 1 2 3 4

34. When I am with people I

don’t feel part of things 1 2 3 4

35. I am more tense than usual

1 2 3 4

36. I’ve felt like things are out

of my control 1 2 3 4

37. I haven’t been interested in

getting ahead 1 2 3 4
none or some of the most of the all of the
little of the time time time
time
1 2 3 4
38. I haven’t felt like a sexual
man 1 2 3 4

39. I really can’t rely on

anyone but myself 1 2 3 4

40. Little things have bothered

me more than usual 1 2 3 4

41. I feel like I won’t be able

to keep up with my 1 2 3 4
responsibilities
42. I’ve felt like I am in a pit
1 2 3 4

43. I got so angry I smashed or

punched something 1 2 3 4

44. I am not the man I used to

be 1 2 3 4

45. My muscles have been

tense 1 2 3 4

46. I’ve felt angry at myself

1 2 3 4

47. Little things stress me out

1 2 3 4

48. People have constantly

been on my case 1 2 3 4

49. I’ve pulled back from

family and friends 1 2 3 4

50. The odds are against me

1 2 3 4

51. I’ve needed to handle my

problems on my own 1 2 3 4

none or some of the most of the all of the

little of the time time time
time
1 2 3 4
52. I don’t feel as powerful
1 2 3 4

53. I’ve been getting angry

1 2 3 4

54. I’ve felt like I have a

heavy weight on my chest 1 2 3 4

55. I’ve been less interested in

succeeding 1 2 3 4

56. I have used recreational

drugs a lot 1 2 3 4

57. I’ve felt trapped

1 2 3 4

58. The pressure in my life has

gotten more intense 1 2 3 4