If you are still deciding to take the screening questions, these are posted below:
This survey is part of a screening to see if you can take part in the research study. The information is not to make a diagnosis. If you have urgent issues or are in crisis, please call or text the toll-free hotline, 988, for help.
1) What are you primarily being treated for?
- Depressive Symptoms
- Anxiety Symptoms
- Both
- Neither?
2) Enter your Date or birth and today’s date. The secure platform will calculate your age
3). PHQ-8 Modified for Teens: Patient Health Questionnaire
Instructions: How often have you been bothered by each of the following symptoms during the past two weeks? For each symptom, click the box that best describes how you are feeling. For each question, you will choose: Not at all; Several Days, More than Half the Days, or Nearly Every Day
A) Feeling down, depressed, irritable, or hopeless?
B) Little interest or pleasure in doing things?
C) Trouble falling asleep, staying asleep, or sleeping too much?
D) Feeling tired, or having little energy?
E) Poor appetite, weight loss, or overeating?
F) Feeling bad about yourself, or feeling that you are a failure, or that you let yourself, or your family down?
G) Trouble concentrating on things like school work, reading, or watching TV?
H) Moving or speaking so slowly that other people could have noticed? Or the opposite: being so fidgety or restless that you were moving around a lot more than usual?
GAD-7 Generalized Anxiety Disorder- 7 questions
Instructions: How often have you been bothered by each of the following symptoms during the past two weeks? For each question, you will choose: Not at all; Several Days, More than Half the Days, or Nearly Every Day
A) Feeling nervous, anxious, or on edge?
B) Not being able to stop or control worrying?
C) Worrying too much about different things?
D) Trouble relaxing?
E) Being so restless that it is hard to sit still?
F) Becoming easily annoyed or irritable?
G) Feeling afraid, as if something awful might happen?
Before you submit the survey, please enter your name and e-mail. This is needed for the consent to participate.
