1. Do you worry about the future?
2. Do you sometimes have trouble falling asleep?
3. Do you often reach for a cigarette, a drink, or a tranquilizer in order to reduce tension?
4. Do you become irritated over basically insignificant matters?
5. Do you have less energy than you seem to need or would like to have?
6. Do you have too many things to do and not enough time to do them?
7. Do you have headaches or stomach problems?
8. Do you feel pressure to accomplish or to get things done?
9. Are you very concerned about being either well-liked or successful?
10. Do you perform well enough in life to satisfy your basic needs?
11. Do you get satisfaction from the small joys or simple pleasures of life?
12. Are you able to really relax and have fun?