GADQ

Your birthdate and date of your first DBTCSD therapy session are needed for us to identify your data while keeping it anonymous to others. Your data will be transmitted securely as scrambled numbers without any text labels.
Birthday year
Name of therapist (primary therapist)
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Do you experience excessive worry?
Is your worry excessive in intensity, frequency, or amount of distress it causes?
Do you find it difficult to control your worry (or stop worrying) once it starts?
Do you worry excessively and uncontrollably about minor things such as being late for an appointment, minor repairs, homework, etc.?

During the last six months, have you often been bothered by excessive and uncontrollable worries more days than not?
IF YES, CONTINUE. IF NO, DISCONTINUE.

During the last six months, have you often been bothered by restlessness or feeling keyed up or on edge more days than not?
During the last six months, have you often been bothered by difficulty falling/staying asleep or restless/unsatisfying sleep more days than not?
During the last six months, have you often been bothered by difficulty concentrating or your mind going blank more days than not?
During the last six months, have you often been bothered by irritability more days than not?
During the last six months, have you often been bothered by being easily fatigued more days than not?
During the last six months, have you often been bothered by muscle tension more days than not?
How much do worry and physical symptoms interfere with your life, work, social activities, family, etc.?
How much are you bothered by worry and physical symptoms (how much distress does it cause you)?