Generalized Anxiety Disorder Scale

PID-5 Form
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Today's Date*

MonthDayYear
Date
This is a list of things different people might say about themselves.We are interested in how you would describe yourself. There are no right or wrong answers, so you can describe yourself as honestly as possible. Read each statement carefully - take your time.
1. People would describe me as reckless*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
2. I feel like I act totally on impulse*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
3. Even though I know better, I can't stop making rash decisions*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
4. I often feel like nothing I do really matters*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
5. Others see me as irresponsible*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
6. I'm not good at planning ahead*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
7. My thoughts often don't make sense to others*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
8. I worry about almost everything*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
9. I get emotional easily, often for very little reason*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
10. I fear being alone in life more than anything else*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
11. I get stuck on the way of doing things, even when it's clear it won't work*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
12. I have seen things that weren't really there*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
13. I steer clear of romantic relationships*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
14. I'm not interested in making friends*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
15. I get irritated easily by all sorts of things*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
16. I don't like to get too close to people*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
17. It's no big deal if I hurt other peoples' feelings*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
18. I rarely get enthusiastic about anything*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
19. I crave attention*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
20. I often have to deal with people who are less important than me*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
21. I often have thoughts that make sense to me but that other people say are strange*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
22. I use people to get what I want*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
23. I often "zone out" and then suddenly come to and realize that a lot of time has passed*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
24. Things around me often feel unreal, or more real than usual*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
25. It is easy for me to take advantage of others*

Very False OR Often FalseSometimes OR Somewhat FalseSometimes OR Somewhat TrueVery True OR Often True
Personality Trait Domain: Negative Affect*
0-15
Personality Trait Domain: Detachment*
0-15
Personality Trait Domain: Antagonism*
0-15
Personality Trait Domain: Disinhibition*
0-15
Personality Trait Domain: Psychoticism*
0-15
Overall Personality Dysfunction*
0-75
Should be Empty: