0 Did not apply to me at all NEVER – 1 Applied to me to some degree, or some of the time - SOMETIMES 2 Applied to me to a considerable degree, or a good part of time - OFTEN 3 Applied to me very much, or most of the time - ALMOST ALWAYS 0 1 2 3 Please tick the appropriate column I it hard to wind down 0 1 2 3 I was aware of dryness of my mouth 0 1 2 3 I couldn’t seem to experience any positive feeling at all 0 1 2 3 I experienced breathing difficulty (e.g., excessively rapid breathing, breathlessness in 0 1 2 3 the absence of physical exertion) I it difficult to work up the initiative to do things 0 1 2 3 I tended to over-react to situations 0 1 2 3 I experienced trembling (e.g., in the hands) 0 1 2 3 I felt that I was using a lot of nervous energy 0 1 2 3 I was worried about situations in which I might panic and make a fool of myself 0 1 2 3 I felt that I had nothing to look forward to 0 1 2 3 I found myself getting agitated 0 1 2 3 I found it difficult to relax 0 1 2 3 I felt down-hearted and blue 0 1 2 3 I was intolerant of anything that kept me from getting on with what I was 0 1 2 3 I felt I was to panic 0 1 2 3 I was unable to become enthusiastic about anything 0 1 2 3 I felt I wasn’t worth much as a person 0 1 2 3 I felt that I was rather touchy 0 1 2 3 I was aware of the action of my heart in the absence of physical exertion (e.g., sense 0 1 2 3 of heart rate increase, heart missing a beat) I felt scared without any good reason 0 1 2 3 I felt that life was meaningless 0 1 2 3 Section 19 Personal and Household Hygiene Questionnaire – Personal hygiene please tick the option that applies most accurately to you – 1. Upon getting home, do you wash your
0 Did not apply to me at all – NEVER 1 Applied to me to some degree, or some of the time - SOMETIMES 2 Applied to me to a considerable degree, or a good part of time - OFTEN 3 Applied to me very much, or most of the time - ALMOST ALWAYS Please tick the appropriate column 0 1 2 3 I it hard to wind down 0 1 2 3 I was aware of dryness of my mouth 0 1 2 3 I couldn’t seem to experience any positive feeling at all 0 1 2 3 I experienced breathing difficulty (e.g., excessively rapid breathing, breathlessness in the absence of physical exertion) 0 1 2 3 I it difficult to work up the initiative to do things 0 1 2 3 I tended to over-react to situations 0 1 2 3 I experienced trembling (e.g., in the hands) 0 1 2 3 I felt that I was using a lot of nervous energy 0 1 2 3 I was worried about situations in which I might panic and make a fool of myself 0 1 2 3 I felt that I had nothing to look forward to 0 1 2 3 I found myself getting agitated 0 1 2 3 I found it difficult to relax 0 1 2 3 I felt down-hearted and blue 0 1 2 3 I was intolerant of anything that kept me from getting on with what I was 0 1 2 3 I felt I was to panic 0 1 2 3 I was unable to become enthusiastic about anything 0 1 2 3 I felt I wasn’t worth much as a person 0 1 2 3 I felt that I was rather touchy 0 1 2 3 I was aware of the action of my heart in the absence of physical exertion (e.g., sense of heart rate increase, heart missing a beat) 0 1 2 3 I felt scared without any good reason 0 1 2 3 I felt that life was meaningless 0 1 2 3 Section 19 – Personal and Household Hygiene Questionnaire Personal hygiene – please tick the option that applies most accurately to you 1. Upon getting home, do you wash your
C.-SNI-SI-Medical-Performance-Profiling-Questionnaire.docx