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I am concerned about a behavior, feeling, or certain thoughtsthat have been a problem to me.
I am unhappy and dissatisfied about some or whole aspects ofmyself and/or my life.
I spend increasing amount of time every week thinking aboutthe problem and/or trying to find some solution to it.
I have been trying to solve this problem by myself or with helpof family and friends but haven’t got any success.
I have read books and looked up the internet to understandthings better.
Over the past 2 weeks, this problem has reduced my quality oflife.
The problem has affected my lifestyle (eating, sleeping,working, pleasurable activities).
I have tried to avoid this problem because it’s veryuncomfortable to deal with it or I am ashamed of it.
I have tried to deal with it by relying on one or more of alcohol,drugs, shopping, internet and technology.
I am preoccupied with this problem/over thinking about it muchof the time.
I have difficulties concentrating and efficiently performing thetasks at hand.
This problem has affected me emotionally. (I feel strongemotions as depression, anxiety, shame and anger about it).
This problem has affected/will affect my relationships andsocial interaction.
I am experiencing physical problems as headaches, pains,tiredness etc along with this problem.
My family and friends have notices that I am stressed orworried about something.
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