Instructions: Below is a list of problems and complaints that people sometimes have. Read each one carefully. INDICATE HOW MUCH THAT PROBLEM HAS BOTHERED OR DISTRESSED YOU DURING THE PAST WEEK INCLUDING TODAY. In each adjacent box, check one answer for each problem. Please use the following scale:

Please click here for an interpretation of the scored responses.

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 Not at all   A little bit   Moderately  Quite a bit   Extremely                                                                                                                                                                                                                (1)          (2)             (3)            (4)             (5)

                                                                                     How much were you bothered by the following:

                                                         1.  Nervousness or shakiness inside

                                                         2.  The idea that someone else can control your thoughts

                                                         3.  Feeling others are to blame for most of your troubles.

                                                         4.  Thoughts of ending your life.

                                                         5.  Hearing voices that other people do not hear. 

                                                         6. Suddenly scared for no reason.

                                                         7.  Temper outbursts that you could not control.

                                                         8.  Feeling blue.

                                                         9.  Feeling that people are unfriendly or dislike you

                                                        10. Having to check and double check what you do.

                                                        11. Difficulty making decisions.

                                                        12. Feeling hopeless about the future.

                                                        13. Feeling tense of keyed up.

                                                        14. Feeling uneasy when people are watching or talking about you.

                                                        15. Having urges to beat, injure, or harm someone.

                                                        16. Having urges to break or smash something.

                                                        17. Feeling self-conscious with others.

                                                        18. Spells of terror or panic.

                                                        19. Feelings of worthlessness.

                                                        20. Feeling most people will take advantage of you if you let them.

Please click here for an interpretation of the scored responses.

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Source: U.S. Department of Health and Human Services and National Institute on Drug Abuse. Research Issue 28, Assessing Marijuana Consequences: Selected Questionnaire Items. (DHHS Publication No. (ADM) 81-1150). Washington, D.C.: U.S.  Government Printing Office, 1981.