Answer each question by designating either T for true or F for false. Complete this form on your computer, the results will be automatically calculated and displayed at the end of the assessment. Bring the results with you to the clinic.

Answer the questions in terms of how you feel most of the time. For example, if you've had a bad night's sleep and feel tired today answer the questions that pertain to your energy levels based on how you feel on a more average day.


Section 1A

Memory and Attention

I find it easy to process my thoughts True False
I concentrate effectively True False
I am a deep thinker True False
I am a quick thinker True False
I become distracted because I do so many tasks at once True False
I enjoy intense debate True False
I have a good imagination True False
I tend to criticize and analyze my thoughts True False


I have a lot of energy most of the time True False
My blood pressure is often elevated True False
Sometimes in my life I have had episodes of extreme energy True False
I have insomnia True False
I find exercising invigorating True False
I don't ordinarily need coffee to jump-start me in the morning True False
My veins are visible and tend to look as though they might pop out of my skin. True False
I tend to have a high body temperature True False
I eat my lunch while I'm working True False
I engage in sexual intercourse any chance I get True False
I have a temper True False
I eat only to reenergize by body True False
I love action movies True False
Exercising makes me feel powerful True False


I am a very domineering individual. True False
I sometimes don't notice my feelings True False
I often have trouble listening to others because my own ideas dominate True False
I have been in many physical altercations True False
I tend to be future-oriented True False
I am sometimes speculative True False
Most people view me as thinking-oriented True False
I daydream and often fantasize True False
I like to read history and other nonfiction books True False
I admire ingenuity True False
I can be slow in identifying how people can cause trouble True False
I don't usually get tricked by people who say they need my help True False
Most people view me as innovative True False
People have thought I have had some strange ideas, but I can always explain the basis for them rationally True False
I am often agitated or irritated True False
Little things make me anxious or upset True False
I have fantasies of unlimited power True False
I love spending money True False
I dominate others in my relationships True False
I am very hard on myself True False
I react aggressively to criticism; often becoming defensive in front of others True False


Some individuals view me as tough-minded True False
Most people view me as achievement-oriented True False
Some people say that I am irrational True False
I will do anything to reach a goal True False
I value a religious philosophy True False
Incompetence makes me angry True False
I have high standards for myself and for others True False

You have completed part 1A.
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