ANOREXIA:
[] You have dry skin.
[] You eat one meal.
[] You're very weak.
[] You hate yourself.
[] You starve yourself.
[] You have low self esteem.
[] You use laxatives.
[] You need to be more skinny.
[] People always say you're skinny, but you think you're fat.
[] People think you are too skinny.
TOTAL: 0
ATTENTION DEFICIT HYPERACTIVE DISORDER:
[x] Your mind is all over the place.
[x] You are hyper most of the time.
[] You barely pay attention to anything
[] You can't cooperate well.
[] You talk all the time
[] You need attention 24/7.
TOTAL: 2
BIPOLAR DISORDER:
[x] You can act wild at times then the next day you are depressed.
[x] You are very irritable.
[x] You are antisocial.
[x] You have very high self esteem sometimes.
[] You are abusing alcohol, drugs, or sex.
[x] You have thought of or attempted suicide
TOTAL: 5
BULIMIA:
[] You throw up all of your food.
[] You throw it up even when you don't feel sick.
[] You have no control over how you eat.
[] You use laxatives.
[] You have overly exercised to where you almost fainted.
[] You always say you are fat, when you aren't.
[] People think you're way too skinny.
TOTAL: 0
CONDUCT DISORDER:
[] You are a bully.
[] You threaten other people.
[] You often find yourself in fights.
[] You have used a weapon that could cause injury to others.
[] You are cruel to humans or animals.
[] You have raped or molested someone.
[] You destroyed property on purpose.
[] You always lie.
[] You stay out all night.
[] You have/tried to run away from home.
TOTAL: 0
DEPRESSION:
[] You are always sad.
[] You find no hope in your future.
[x] You find no longer excitement over the activities you used to love.
[X] You always find yourself around the house all day.
[] You have low self esteem.
[] Everything bad that happens is always your fault
[] You always seem to be weak or have physical features hurt.
[] You are failing school
[X] You have thought of or attempted suicide.
[] You have/tried or attempted suicide.
TOTAL: 2
OBSESSIVE COMPULSIVE DISORDER:
[] You have daily rituals.
[x] You have disturbing thoughts or thoughts you hate.
[x] You have to do a certain thing until it feels right.
[x] You have to keep things in a certain order.
[x] You have harmed yourself.
[x] You have to check some stuff over again.
TOTAL: 5
POST-TRAUMATIC STRESS DISORDER:
[] You repeatedly have flashbacks of horrible moments or memories in your life.
[] You repeatedly have dreams of horrible moments or memories in your life.
[x] You sometimes think the event will happen again.
[] You can be/are antisocial.
[x] You have lost interest in the things you used to love.
[] You have not had a lot of sleep lately.
[] You worry about dying at a early age or dying at all.
[x] You can have angry outbursts.
[] You act younger than your age.
TOTAL: 3
SCHIZOPHRENIA:
[] You often have hallucinations
[x] You have strange, unusual dreams or thoughts.
[x] You can be confused about reality and fantasy.
[] You think people are always staring or talking about you.
[] You have extreme anxiety or fearfulness.
[] You do not take care of your hygiene like you should.
[] You are very shy.
[x] You often talk to yourself
TOTAL: 3










