Please read each statement and select a number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past week. There are no right or wrong answers. Do not spend too much time on any statement.

The rating scale is as follows:

0 Did not apply to me at all - NEVER
1 Applied to me to some degree, or some of the time - SOMETIMES
2 Applied to me to a considerable degree, or a good part of time - OFTEN
3 Applied to me very much, or most of the time - ALMOST ALWAYS

The DASS is a quantitative measure of distress along the 3 axes of depression, anxiety* and stress**. It is not a categorical measure of clinical diagnoses.

Emotional syndromes like depression and anxiety are intrinsically dimensional - they vary along a continuum of severity (independent of the specific diagnosis). Hence the selection of a single cut-off score to represent clinical severity is necessarily arbitrary. A scale such as the DASS can lead to a useful assessment of disturbance, for example individuals who may fall short of a clinical cut-off for a specific diagnosis can be correctly recognised as experiencing considerable symptoms and as being at high risk of further problems.


However for clinical purposes it can be helpful to have ‘labels’ to characterise degree of severity relative to the population. Thus the following cut-off scores have been developed for defining mild/moderate/severe/ extremely severe scores for each DASS scale.


Note: the severity labels are used to describe the full range of scores in the population, so ‘mild’ for example means that the person is above the population mean but probably still way below the typical severity of someone seeking help (ie it does not mean a mild level of disorder.


The individual DASS scores do not define appropriate interventions. They should be used in conjunction with all clinical information available to you in determining appropriate treatment for any individual.

*Symptoms of psychological arousal
**The more cognitive, subjective symptoms of anxiety

The Insomnia Severity Index has seven questions. For each question, please SELECT the option that best describes your answer. After submitting this form you will get the total Score and Your sleep difficulty.

Please rate the CURRENT (i.e. LAST 2 WEEKS) SEVERITY of your insomnia problem(s).

Yout Total Score is: {youtTotal}

Your sleep difficulty is: {totalScore12}

Used via courtesy of www.myhealth.va.gov with permission from Charles M. Morin, Ph.D., Université Laval

How can you determine how much CSP is contributing to someone’s pain?

The Central Sensitization Inventory (CSI) may be used to determine severity of CSP. The CSI consists of 25 questions and may be self‐administered. Each question may be answered as follows:

Never (0 points), Rarely (1 point), Sometimes (2 points), Often (3 points), or Always (4 points).

Total points reflect the severity of the CSP. Following is a breakdown of score ranges and the intensity of CSP they represent.

Subclinical: 0 to 29
Mild: 30 to 39
Moderate: 40 to 49
Severe: 50 to 59
Extreme: 60 to 100

The CSI has two parts, Part A and Part B. For scoring purposes you will only look at the 25 questions in Part A. Part B was initially used to help correlate the results with previous diagnoses. For our purposes it adds additional clinical background information but isn’t included when the instrument is scored.

Please circle the best response to the right of each statement.
Key for Scoring:
Never = 0, Rarely = 1, Sometimes = 2, Often = 3, Always = 4

Your Total Score is: {overallTotal}

{intensityOf}

Have you been diagnosed by a doctor with any of the following disorders?

Copyright © 2017, Martha Teater & Don Teater. Chronic Pain. All rights reserved.

Everyone experiences painful situations at some point in their lives. Such experiences may include headaches, tooth pain, joint or muscle pain. People are often exposed to situations that may cause pain such as illness, injury, dental procedures or surgery.

Instructions:
We are interested in the types of thoughts and feelings that you have when you are in pain. Listed below are thirteen statements describing different thoughts and feelings that may be associated with pain. Using the following scale, please indicate the degree to which you have these thoughts and feelings when you are experiencing pain.

Copyright 1995 Michael J.L. Sullivan. Reproduced with permission.
Source: Sullivan MJL, Bishop S, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess, 1995, 7: 524-532