General Mental Health Questionnaire

This questionnaire helps you reflect on your psychological well-being. It is important to emphasize that this is not a diagnostic test and cannot be used to make a diagnosis. Rather, it's a starting point for self-exploration and gaining a deeper understanding of your mental and emotional health. The questions cover various aspects, including mood, relationships, and behaviors. This questionnaire can help identify potential areas for growth and provide insights for a possible further discussion.

This questionnaire is fairly comprehensive and may take approximately 10 minutes to complete. We recommend setting aside uninterrupted time in a quiet environment to allow for focused reflection.

Your responses will remain confidential and are for your personal use. You can use them for personal reflection, or if you wish, we can discuss them together. In any case, they will not be shared with third parties without your consent. If you'd like, I'm available for further discussion.

DISCLAIMER

If you believe you are having a medical emergency, you should immediately contact your local emergency services or go to the nearest hospital.

By using this website and taking this test, you understand and agree to the following: The results of this test are for general informational purposes only. They are not intended to diagnose, treat, cure, or prevent any medical or mental health condition and should not be interpreted as providing medical or mental health advice. The information from this test should not replace a thorough evaluation by a licensed healthcare professional.

Do not use the information from this test for self-diagnosis or treatment. You should consult your physician or mental health provider to help interpret the test results and apply them to your individual situation. Alternatively, you can schedule an appointment with me, Diego Busiol, for a more detailed discussion of the results.

I, Diego Busiol, am not liable for any advice, findings, assessment results, or any other information, services, or products you obtain through this website. Reliance on the test results is at your own risk. I am not responsible for any direct, indirect, incidental, special, or consequential damages, or lost profits that result directly or indirectly from your use of this test. By voluntarily participating in this test, you agree to waive any and all present and future claims against me, Diego Busiol, related to the test, including but not limited to claims, demands, and/or causes of action which allege negligent acts or omissions, or malpractice.

Question

Question

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Please enter your email*

Please enter your email*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Nervousness or shakiness inside*

Nervousness or shakiness inside*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling lonely*

Feeling lonely*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling easily annoyed or irritated*

Feeling easily annoyed or irritated*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Others not giving you proper credit for your achievements*

Others not giving you proper credit for your achievements*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Spells of terror or panic*

Spells of terror or panic*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling hopeless about the future*

Feeling hopeless about the future*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Temper outbursts that you could not control*

Temper outbursts that you could not control*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling that most people cannot be trusted*

Feeling that most people cannot be trusted*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling tense or keyed up*

Feeling tense or keyed up*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling blue*

Feeling blue*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Getting into frequent arguments*

Getting into frequent arguments*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling no interest in things*

Feeling no interest in things*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling so restless you couldn’t sit still*

Feeling so restless you couldn’t sit still*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feelings of worthlessness*

Feelings of worthlessness*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Having urges to beat, injure, or harm someone*

Having urges to beat, injure, or harm someone*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling that you are watched or talked about by others*

Feeling that you are watched or talked about by others*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling others are to blame for most of your troubles*

Feeling others are to blame for most of your troubles*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Suddenly scared for no reason*

Suddenly scared for no reason*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling fearful*

Feeling fearful*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Feeling that people will take advantage of you if you let them*

Feeling that people will take advantage of you if you let them*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Thoughts of ending your life*

Thoughts of ending your life*

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DURING THE PAST 7 DAYS, how much were you distressed by:

Having urges to break or smash things*

Having urges to break or smash things*

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In the PAST TWO MONTHS

have you had a panic attack (sudden fear, terror, heart racing, shortness of breath, chest pain, dizziness, feeling of unreality)?*

have you had a panic attack (sudden fear, terror, heart racing, shortness of breath, chest pain, dizziness, feeling of unreality)?*

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In the PAST TWO MONTHS, I have:

felt moments of sudden terror, fear or fright, sometimes out of the blue (i.e., a panic attack)*

felt moments of sudden terror, fear or fright, sometimes out of the blue (i.e., a panic attack)*

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felt anxious, worried, or nervous about having more panic attacks*

felt anxious, worried, or nervous about having more panic attacks*

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had thoughts of losing control, dying, going crazy, or other bad things happening because of panic attacks*

had thoughts of losing control, dying, going crazy, or other bad things happening because of panic attacks*

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felt a racing heart, sweaty, trouble breathing, faint, or shaky*

felt a racing heart, sweaty, trouble breathing, faint, or shaky*

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felt tense muscles, felt on edge or restless, or had trouble relaxing or trouble sleeping *

felt tense muscles, felt on edge or restless, or had trouble relaxing or trouble sleeping *

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avoided, or did not approach or enter, situations in which panic attacks might occur *

avoided, or did not approach or enter, situations in which panic attacks might occur *

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left situations early, or participated only minimally, because of panic attacks *

left situations early, or participated only minimally, because of panic attacks *

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spent a lot of time preparing for, or procrastinating about (putting off), situations in which panic attacks might occur *

spent a lot of time preparing for, or procrastinating about (putting off), situations in which panic attacks might occur *

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distracted myself to avoid thinking about panic attacks *

distracted myself to avoid thinking about panic attacks *

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needed help to cope with panic attacks (e.g., alcohol or medication, superstitious objects, other people) *

needed help to cope with panic attacks (e.g., alcohol or medication, superstitious objects, other people) *

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How much do you agree?

I often insist that things be done exactly my way‚ and I get annoyed when other people try to ‘‘cut corners’’ or perform a job poorly.*

I often insist that things be done exactly my way‚ and I get annoyed when other people try to ‘‘cut corners’’ or perform a job poorly.*

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How much do you agree?

I’m known to be a bit of a perfectionist or "control freak".*

I’m known to be a bit of a perfectionist or "control freak".*

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How much do you agree?

My standards for performance are extremely high‚ I’m never satisfied with ‘‘just getting the job done’’; it needs to be done very‚ very well.*

My standards for performance are extremely high‚ I’m never satisfied with ‘‘just getting the job done’’; it needs to be done very‚ very well.*

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How much do you agree?

I like to attend to details‚ rules‚ lists‚ order‚ and schedules‚ in order to ensure that everything proceeds correctly‚ without errors.*

I like to attend to details‚ rules‚ lists‚ order‚ and schedules‚ in order to ensure that everything proceeds correctly‚ without errors.*

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How much do you agree?

I can be quite stubborn‚ but it’s usually in the service of doing things the right way and not compromising my high standards.*

I can be quite stubborn‚ but it’s usually in the service of doing things the right way and not compromising my high standards.*

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How much do you agree?

My emotions are like a roller-coaster: very intense and quickly going from very high to very low.*

My emotions are like a roller-coaster: very intense and quickly going from very high to very low.*

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How much do you agree?

Often people that I thought would be great turn out to be horrible.*

Often people that I thought would be great turn out to be horrible.*

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How much do you agree?

When I’m really stressed‚ I sometimes start to feel strange‚ weird‚ or paranoid (as if the whole world is against me).*

When I’m really stressed‚ I sometimes start to feel strange‚ weird‚ or paranoid (as if the whole world is against me).*

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How much do you agree?

I sometimes feel so desperate or awful that I have thoughts of wanting to harm or even kill myself.*

I sometimes feel so desperate or awful that I have thoughts of wanting to harm or even kill myself.*

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How much do you agree?

My relationships are usually extremely intense‚ stormy‚ emotional‚ and unstable.*

My relationships are usually extremely intense‚ stormy‚ emotional‚ and unstable.*

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How much do you agree?

I often get so angry or even hateful that I hardly recognize myself later.*

I often get so angry or even hateful that I hardly recognize myself later.*

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How much do you agree?

I get panicky or desperate when I think someone close will leave me or abandon me.*

I get panicky or desperate when I think someone close will leave me or abandon me.*

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How much do you agree?

I often feel empty inside: not sure who I am or where I’m going with my life.*

I often feel empty inside: not sure who I am or where I’m going with my life.*

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How much do you agree?

If something upsets me‚ my emotions can get out of control rather easily.*

If something upsets me‚ my emotions can get out of control rather easily.*

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How much do you agree?

I often do things for a kick or a thrill even though I know they may be self-damaging (e.g.‚ ha‎ving sex with people I hardly know‚ doing drugs‚ getting extremely drunk).*

I often do things for a kick or a thrill even though I know they may be self-damaging (e.g.‚ ha‎ving sex with people I hardly know‚ doing drugs‚ getting extremely drunk).*

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Have you ever experienced a traumatic event, such as:

A life-threatening situation?*

A life-threatening situation?*

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Witnessing violence or serious injury?*

Witnessing violence or serious injury?*

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The sudden death of someone close to you due to a terrible accident or act of violence?*

The sudden death of someone close to you due to a terrible accident or act of violence?*

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Sexual violence?*

Sexual violence?*

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In the PAST MONTH, how much were you bothered by:

Repeated, disturbing, and unwanted memories of the stressful experience? *

Repeated, disturbing, and unwanted memories of the stressful experience? *

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Repeated, disturbing dreams of the stressful experience? *

Repeated, disturbing dreams of the stressful experience? *

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Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?*

Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?*

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Feeling very upset when something reminded you of the stressful experience? *

Feeling very upset when something reminded you of the stressful experience? *

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Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)? *

Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)? *

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Avoiding memories, thoughts, or feelings related to the stressful experience? *

Avoiding memories, thoughts, or feelings related to the stressful experience? *

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Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)? *

Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)? *

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Trouble remembering important parts of the stressful experience? *

Trouble remembering important parts of the stressful experience? *

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Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)? *

Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)? *

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Blaming yourself or someone else for the stressful experience or what happened after it? *

Blaming yourself or someone else for the stressful experience or what happened after it? *

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Having strong negative feelings such as fear, horror, anger, guilt, or shame? *

Having strong negative feelings such as fear, horror, anger, guilt, or shame? *

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Loss of interest in activities that you used to enjoy? *

Loss of interest in activities that you used to enjoy? *

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Feeling distant or cut off from other people? *

Feeling distant or cut off from other people? *

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Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)? *

Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)? *

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Irritable behavior, angry outbursts, or acting aggressively? *

Irritable behavior, angry outbursts, or acting aggressively? *

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Taking too many risks or doing things that could cause you harm? *

Taking too many risks or doing things that could cause you harm? *

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Being “superalert” or watchful or on guard? *

Being “superalert” or watchful or on guard? *

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Feeling jumpy or easily startled? *

Feeling jumpy or easily startled? *

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Having difficulty concentrating? *

Having difficulty concentrating? *

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Trouble falling or staying asleep? *

Trouble falling or staying asleep? *

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Please, answer Yes or No

I have eating binges where I eat abnormally large amounts of food, far more than a person would normally eat. *

I have eating binges where I eat abnormally large amounts of food, far more than a person would normally eat. *

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How much do you agree?

During these eating binges I feel that my eating is out of control.*

During these eating binges I feel that my eating is out of control.*

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After these eating binges I sometimes make myself vomit.*

After these eating binges I sometimes make myself vomit.*

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On average, I have been doing this (eating and vomiting) twice a week or more.*

On average, I have been doing this (eating and vomiting) twice a week or more.*

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This eating and vomiting has been going on for three months or longer.*

This eating and vomiting has been going on for three months or longer.*

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Would you say Food dominates your life?*

Would you say Food dominates your life?*

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Are you satisfied with your eating patterns?*

Are you satisfied with your eating patterns?*

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Do you ever eat in secret?*

Do you ever eat in secret?*

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Have you ever experienced a period of FOUR DAYS or longer where

you felt unusually good, on top of the world, or had an extreme amount of energy all or nearly all the time, to such an extent that people thought you were not acting like yourself, or you got yourself into trouble?*

you felt unusually good, on top of the world, or had an extreme amount of energy all or nearly all the time, to such an extent that people thought you were not acting like yourself, or you got yourself into trouble?*

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Have you ever experienced a period of FOUR DAYS or longer where

you were irritable, angry, or “on edge” all or nearly all the time, to such an extent that you got into physical fights or shouted at people outside your family?*

you were irritable, angry, or “on edge” all or nearly all the time, to such an extent that you got into physical fights or shouted at people outside your family?*

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How much do you agree?

During this SAME period, I was irritable, angry, and “on edge” all or nearly all the time, to such an extent that I got into physical fights or shouted at people outside my family.*

During this SAME period, I was irritable, angry, and “on edge” all or nearly all the time, to such an extent that I got into physical fights or shouted at people outside my family.*

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During this SAME period lasting four days or longer, I did not get tired and I needed much less sleep than usual (for example, I felt completely rested after getting only two or three hours of sleep, or I did not need to sleep at all).*

During this SAME period lasting four days or longer, I did not get tired and I needed much less sleep than usual (for example, I felt completely rested after getting only two or three hours of sleep, or I did not need to sleep at all).*

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During this SAME period, I talked too much without stopping, or talked so fast that people had trouble following me.*

During this SAME period, I talked too much without stopping, or talked so fast that people had trouble following me.*

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During this SAME period, my thoughts were racing through my head nearly all the time.*

During this SAME period, my thoughts were racing through my head nearly all the time.*

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During this SAME period, I was so easily distracted by everything that I could not keep myself on one track.*

During this SAME period, I was so easily distracted by everything that I could not keep myself on one track.*

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During this SAME period, I was active or restless all or nearly all the time, to such an extent that people worried about me or thought I was not acting like myself.*

During this SAME period, I was active or restless all or nearly all the time, to such an extent that people worried about me or thought I was not acting like myself.*

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During this SAME period, I did reckless things I would not normally do, without regard for the consequences (for example, spending a lot of money, having promiscuous sex, driving recklessly, making bad business decisions).*

During this SAME period, I did reckless things I would not normally do, without regard for the consequences (for example, spending a lot of money, having promiscuous sex, driving recklessly, making bad business decisions).*

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During this SAME period lasting four days or longer, I felt I could accomplish anything or solve any problem.*

During this SAME period lasting four days or longer, I felt I could accomplish anything or solve any problem.*

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During this SAME period, I felt that I was a very special and important person.*

During this SAME period, I felt that I was a very special and important person.*

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Anxiety

Anxiety

0
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Mood

Mood

0
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Anger

Anger

0
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Interpersonal distrust

Interpersonal distrust

0
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Panic attacks

Panic attacks

0
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Perfectionism and control

Perfectionism and control

0
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Emotional and relational stability

Emotional and relational stability

0
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Reactions to stressful events

Reactions to stressful events

0
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Binge Eating patterns

Binge Eating patterns

0
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(hypo)-Mania

(hypo)-Mania

0
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