Download - Project Mansi 2
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In The following questionnaire,I am going to ask you a variety of questions
some are connected with the problems you faced and some are general.There are
options for every single question.Please tick ( ) mark to only those answers
to which you strongly agree.You are required to tick mark only one answer of
each question.
Im simply interested in knowing your interest and perception of your
life.Please complete all the questions carefully as possible.
All your answers in the questionnaire will be treated as confidential
May I thank you for your co-operation
Mansoora Rizvi (Research Investigator)
PGDRP Student
Name: Age . Sex: .
Family Status: (Nuclear/Joint Broken)
Occupation: ...
Education: (Literate/Illiterate)
Mention Qualification, if Any .
Monthly Income:
Address: .
Rural/Urban: .
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1. Do you have loss of balance of your mind even under ordinary pressure?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
2. Do you sometimes feel that life is useless?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
3. Do you have constantly have strain in your nervous system?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time4. Do you feel lack of sleep?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
5. Do you generally think that life will remain sad?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
6. Do you generally feel that you are helpless?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
7. Do you generally work under the conditions of strain?a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
8. Do you feel that your life is in dark?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
9. Do you think life is full of despair?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
10. Do you generally have the feeling of loss rather than gain?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
11. Do you generally have the feeling of least failure?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
12. Do you generally afraid of seeing the crowd?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
13. Do you feel restless?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
14. Do you have less interest in other affair?.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
15. Do you attend parties?
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
16. Once you wake up,it is hard to get back to sleep
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
17. I feel down hearted, blue and sad?
a. None or little the time b. Some of the time
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c. Good part of time d. Most or all the time
18. I find it easy to do things, I used to
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
19. Morning is when I feel the best.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
20. I have trouble sleeping, through night.
a. None or little the time b. Some of the timec. Good part of time d. Most or all the time
21. I eat as much as I used to.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
22. I notice that I am loosing the weight.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
23. I have trouble with constipation.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
24. My heart beats faster than usual.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
25. My mind is as clear as it is used.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
26. I am restless and cant keep still.
a. None or little the time b. Some of the time
c. Good part of time d. Most or al l the time
27. I feel hopeful about the future.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
28. I am more irritable than usual.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
29. I find it easy to make decisions.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
30. I feel that others would be better off, if I were dead.
a. None or little the time b. Some of the time
c. Good part of time d. Most or all the time
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1. Are you happiest when you get involved in some project that calls for rapid action?
Yes ? No
2. Do you sometimes feel happy, sometimes depressed without any apparent reason?
Yes ? No
3. Do your mind often wander while you are trying to concentrate on some topic?
Yes ? No
4. Are you frequently lost in thoughts even when you are conversing?Yes ? No
5. Would you be unhappy if you were prevented form making social contacts?
Yes ? No
6. Do you have frequent ups and downs in your mood?
Yes ? No
7. Does your behavior keeps changing without any apparent cause?
Yes ? No
8. Are your day dreams frequently about things that can never come true?
Yes ? No
9 Are you inclined to ponder over your past?
Yes ? No
10. Do you find it difficult to mix with people even at lively party?
Yes ? No
11. Do you often feel that you have made up your mind too late to do something?
Yes ? No
13. Do you like to mix socially with people?
Yes ? No
14. Have you often lost sleep over your worries?
Yes ? No
15. Are you often troubled by feeling of sin or guilt?
Yes ? No
16. Do you feel rather hurt very easily?
Yes ? No17. Would you rate yourself as a tense or highly strung individual?
Yes ? No
18. Do you generally prefer to take the leadership in a group?
Yes ? No
19. Do you often experience periods of loneliness?
Yes ? No
20. Are you inclined to be shy in the presence of the opposite sex?
Yes ? No