SDQ FORM Youth Ages 11-17

SDQ FORM

Youth ages 11-17
For eac item, please select the box for Not True, Somewhat True, or Certainly True. It would help us if you answered all items as best you can even if you are not absolutely certain. Please give your answers on the basis of how things have been for you over the past 6 months.
Your Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender

MaleFemaleOther
Therapist you’re scheduled with*

First NameLast Name
I try to be nice to other people. I care about their feelings

Not TrueSomewhat TrueCertainly True
I am restless, I cannot stay still for long

Not TrueSomewhat TrueCertainly True
I get a lot of headaches, stomach-aches or sickness

Not TrueSomewhat TrueCertainly True
I usually share with others, for example CD's, games, food

Not TrueSomewhat TrueCertainly True
I get very angry and often lose my temper

Not TrueSomewhat TrueCertainly True
I would rater be along than with people of my age

Not TrueSomewhat TrueCertainly True
I usually do as I am told

Not TrueSomewhat TrueCertainly True
I worry a lot

Not TrueSomewhat TrueCertainly True
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I am helpful if someone is hurt, upset or feeling ill

Not TrueSomewhat TrueCertainly True
I am constantly fidgeting or squirming

Not TrueSomewhat TrueCertainly True
I have one good friend or more

Not TrueSomewhat TrueCertainly True
I fight a lot. I can make other people do what I want

Not TrueSomewhat TrueCertainly True
I am often unhappy, depressed or tearful

Not TrueSomewhat TrueCertainly True
Other people my age generally like me

Not TrueSomewhat TrueCertainly True
I am easily distracted, I find it difficult to concentrate

Not TrueSomewhat TrueCertainly True
I am nervous in new situations. I easily lose confidence

Not TrueSomewhat TrueCertainly True
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I am kind to younger children

Not TrueSomewhat TrueCertainly True
I am often accused of lying or cheating

Not TrueSomewhat TrueCertainly True
Other children or young people pick on me or bully me

Not TrueSomewhat TrueCertainly True
I often offer to help others (parents, teachers, children)

Not TrueSomewhat TrueCertainly True
I think before I do things

Not TrueSomewhat TrueCertainly True
I take things that are not mine from home, school or elsewhere

Not TrueSomewhat TrueCertainly True
I get along better with adults than with people my own age

Not TrueSomewhat TrueCertainly True
I have many fears, I am easily scared

Not TrueSomewhat TrueCertainly True
I finish the work that I am doing. My attention is good

Not TrueSomewhat TrueCertainly True
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