COMPOSITE MEASURES

INDEX EXAMPLE

Place a check mark in from of each feeling that you have experienced during the past week:

______ Sadness

______ Hopelessness

______ Powerlessness

______ Just not caring

______ Wanting to be alone

______ Anxiety

SCALE EXAMPLE

Indicate how often you experienced each of these symptoms by circling the appropriate number.

Never Often

1. Sad/down 0 1 2 3 4

2. Hopeless 0 1 2 3 4

3. Powerless 0 1 2 3 4

4. Apathetic 0 1 2 3 4

5. Withdrawn 0 1 2 3 4

6. Anxious 0 1 2 3 4