Preliminary Self-Evaluation Questionnaires
If you or a loved one is concerned about your consumption of alcohol, drugs and/or your compulsive pursuit and engagement in lustful behavior but are unsure whether or not you want to seek outside help then perhaps these tools can help you in the decision process. The screening tools below are designed so that they can be completed by the individual but please understand that these tools are not diagnostic tools and are not a suitable replacement for a thorough evaluation with professional who specializes in the treatment of addictive disorders.
Each of the tools will include instructions about how to score your answers. In each, if you answer yes to a certain number of items, it suggests that you may have a problem and that further evaluation is indicated. If you are interested in a more comprehensive evaluation or are concerned and would like to begin treatment please do not hesitate to contact us.
Available Screening Tools
CAGE
The CAGE questionnaire has been extensively validated for use in identifying alcoholism. It is considered a validated self-report screening tool.
CAGE Questionnaire
The CAGE questionnaire has been extensively validated for use in identifying alcoholism. It is considered a validated screening technique. Two positive responses are considered a positive test and indicate further assessment is warranted.
PATHOS
PATHOS is a brief sexual addiction screening questionnaire developed by Patrick Carnes. It has been found in studies to be a valid screening tool.
PATHOS Questionnaire
In a 2012 study headed by Dr. Patrick Carnes, it was estimated that sexual addiction afflicts up to 3% to 6% of the population. However, many clinicians lack clear criteria for detecting potential cases.
PATHOS is a brief sexual addiction screening questionnaire. The clinical study from Carnes, et al., found PATHOS as clinically significant for effectively classifying patient's appropriateness for entering treatment as potential sex addicts.
DAST-10
DAST-10 is a self-report screening tool designed to assess the severity of drug abuse in individuals. It has been found to be a valid screening tool.
Drug Abuse Screening Test (DAST-10)
The following questions concern information about your possible involvement with drugs not including alcoholic beverages during the past 12 months.
"Drug abuse" refers to (1) the use of prescribed or over-the-counter drugs in excess of the directions, and (2) any nonmedical use of drugs.
The various classes of drugs may include cannabis (marijuana, hashish), solvents (e.g., paint thinner), tranquilizers (e.g., Valium), barbiturates, cocaine, stimulants (e.g., speed), hallucinogens (e.g., LSD) or narcotics (e.g., heroin). Remember that the questions do not include alcoholic beverages.
Please answer every question. If you have difficulty with a statement, then choose the response that is mostly right.
In the past 12 months…
Scoring: Score 1 point for each question answered “Yes.”
| Score | Degree of Problems | Suggested Action |
|---|---|---|
| 0 | No problems reported | None at this time |
| 1–2 | Low level | Monitor, re-assess at a later date |
| 3–5 | Moderate level | Further investigation |
| 6–8 | Substantial level | Intensive assessment |
| 9–10 | Severe level | Intensive assessment |
Drug Abuse Screening Test (DAST-10). Copyright 1982 by the Addiction Research Foundation.
TSQ
The Trauma Screening Questionnaire is a brief 10-item screening instrument for post-traumatic stress disorder based on reactions to a traumatic event.
Trauma Screening Questionnaire (TSQ)
Your own reactions now to the traumatic event
Please consider the following reactions which sometimes occur after a traumatic event. This questionnaire is concerned with your personal reactions to the traumatic event which happened to you. Please indicate (Yes/No) whether or not you have experienced any of the following at least twice in the past week.
Note: If you have answered yes to 6 or more questions you are encouraged to consider whether some counseling support may be of benefit in helping you to lower your on-going reactions to the traumatic event.
Source: Brewin, C. R., Rose, S., Andrews, B., Green, J., Tata, P., McEvedy, C., Turner, S. & Foa, E. B. (2002) Brief screening instrument for post-traumatic stress disorder. British Journal of Psychiatry, 181, 158–162.
GAD-7
The GAD-7 is a brief 7-item self-report measure for assessing generalized anxiety disorder, widely used in clinical practice and research.
GAD-7
Over the last 2 weeks, how often have you been bothered by the following problems?
| Score | Anxiety Severity |
|---|---|
| 0–4 | Minimal anxiety |
| 5–9 | Mild anxiety |
| 10–14 | Moderate anxiety |
| 15–21 | Severe anxiety |
Source: Spitzer RL, Kroenke K, Williams JBW, Lowe B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.
If you are interested in a more comprehensive evaluation or would like to begin treatment, please do not hesitate to contact us.
Call us at 732-797-1444