SCL-90- R

Adı – Soyadı:

Yaş                    :                                                                     Cinsiyeti :

Açıklama          :                                                                      Tarih      :

Aşağıda zaman zaman herkeste olabilecek yakınma ve sorunların bir listesi vardır. Lütfen her birini dikkatlice okuyunuz. Sonra bu durumun bugün de dahil olmak üzere son bir ay içinde sizi ne ölçüde huzursuz ve tedirgin ettiğini göz önüne alarak aşağıda belirtilen tanımlamalardan uygun olanının numarasını karşısındaki boşluğa yazınız. Düşüncenizi değiştirirseniz ilk yazdığınız numarayı tamamen siliniz. Lütfen başlangıç örneğini dikkatle okuyunuz ve anlamadığınız bir cümle ile karşılaştığınızda uygulayan kişiye danışınız.

Örnek :                                                  Tanımlama :

Aşağıda belirtilen sorundan                                0 Hiç

ne ölçüde rahatsız olmaktasınız?             1 Çok az

Cevap                            2 Orta derecede

                                      3 Oldukça fazla

                          4 Aşırı düzeyde

Örnek : Bel ağrısı ... 3 ...

 

1.                                                                                                                                                                                                                                                              Baş ağrısı                     

2.                                                                                                                                                                                                                                                              Sinirlilik ya da içinin titremesi                                                                                                                      ...........

3.                                                                                                                                                                                                                                                              Zihinden atamadığınız yineleyici (tekrarlayıcı) hoşa gitmeyen düşünceler                                                         ...........

4.                                                                                                                                                                                                                                                              Baygınlık ve baş dönmeler                                                                                                                    ...........

5.                                                                                                                                                                                                                                                              Cinsel arzuya ilginin kaybı                                                                                                                          ...........

6.                                                                                                                                                                                                                                                              Başkaları tarafından eleştirilme duygusu                                                                                                      ...........

7.                                                                                                                                                                                                                                                              Herhangi bir kimsenin düşüncelerinizi kontrol edebileceği fikri                                                                        ...........

8.                                                                                                                                                                                                                                                              Sorunlarınızdan pek çoğu için başkalarının suçlanması gerektiği fikri                                                                     ...........

9.                                                                                                                                                                                                                                                              Olayları anımsamada (hatırlamada) güçlülük                                                                                                 ...........

10.                                                                                                                                                                                                                                                          Dikkatsizlik veya sakarlıkla ilgili endişeler                                                                                               ...........

11.                                                                                                                                                                                                                                                          Kolayca gücenme, rahatsız olma hissi                                                                                                       ...........

12.                                                                                                                                                                                                                                                          Göğüs veya kalp bölgesinde ağrılar                                                                                                        ...........

13.                                                                                                                                                                                                                                                          Caddelerde veya açık alanlarda korku hissi                                                                                                   ...........

14.                                                                                                                                                                                                                                                          Enerjinizde azalma veya yavaşlama hali                                                                                                             ...........

15.                                                                                                                                                                                                                                                          Yaşamınızın sona ermesi düşünceleri                                                                                                                 ...........

16.                                                                                                                                                                                                                                                          Başka kişilerin duymadıkları sesleri duyma                                                                                          ...........

17.                                                                                                                                                                                                                                                          Titreme.            

18.                                                                                                                                                                                                                                                          Çoğu kişiye güvenilmemesi gerektiği düşüncesi                                                                               ...........

19.                                                                                                                                                                                                                                                          İştah azalması               

20.                                                                                                                                                                                                                                                          Kolayca ağlama            

21.                                                                                                                                                                                                                                                          Karşı cinsten kişilerle ilgili utangaçlık ve rahatsızlık hissi                                                                                 ...........

22.                                                                                                                                                                                                                                                          Tuzağa  düşürülmüş veya tuzağa yakalanmış hissi                                                                                                ...........

23.