Health Psychology & ADHD Institute

  • 1-269-375-0624
  • patricia@smartcounseling.services   •  Patricia R. Williams, LCSW, M.A.

Health Psychology & ADHD Institute

Kalamazoo, MI
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Adult Self-Assessment (v3.1)

Answer these questions according to how you have felt MOST of your adult life … not how you are feeling just today.

1. At home, work, or school, I find my mind wandering from tasks that are uninteresting or difficult.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

2. I find it difficult to read written material unless it is very interesting or very easy.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

3. Especially in groups, I find it hard to stay focused on what is being said in conversations.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

4. I have a quick temper … a short fuse.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

5. I am irritable and get upset by minor annoyances.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

6. I say things without thinking, and later regret having said them.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

7. I make quick decisions without thinking enough about the possible bad results.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

8. My relationships with people are made difficult by my tendency to talk first and think later.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

9. My moods have highs and lows.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

10. I have trouble planning in what order to do a series of tasks or activities.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

11. I easily become upset.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

12. I seem to be thin skinned and many things upset me.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

13. I almost always am on the go.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

14. I am more comfortable when moving than when sitting still.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

15. In conversations, I start to answer questions before the questions have been fully asked.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

16. I usually work on more than one project at a time, and fail to finish many of them.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

17. There is a lot of “static” or “chatter” in my head.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

18. Even when sitting quietly, I am usually moving my hands or feet.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

19. In group activities, it is hard for me to wait my turn.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

20. My mind gets so cluttered that it is hard for it to function.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

21. My thoughts bounce around as if my mind were a pinball machine.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

22. My brain feels as if it were a television set with all the channels going at once.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

23. I am unable to stop daydreaming.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

24. I am distressed by the disorganized way my brain works.

Very Much
Quite a Lot
Moderately
Somewhat
Just a Little
Not At All

 

 

Office Address
Health Psychology / ADHD Institute
3335 S. 9th Street • Kalamazoo, MI 49009
269.375.0624
patricia@smartcounseling.services

Mailing Address
Health Psychology / ADHD Institute
P. O. Box 263 • Oshtemo, MI 49077

(c) 2023 Health Psychology & A.D.D. Institute – Health Psychology & ADHD Institute • All Rights Reserved

Health Psychology & ADHD Institute

Kalamazoo, MI
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  • 1-269-375-0624
  • patricia@smartcounseling.services   •  Patricia R. Williams, LCSW, M.A.
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