Please read each statement and circle a number 0, 1, 2, 3 which indicates how much the statement applied to you over the past week or a typical week. There are no right or wrong answers. Do not spend too much time on any statement.
The rating scale is as follows:
0 Does not apply to me at all – NEVER
1 Applies to me to some degree, or some of the time – SOMETIMES
2 Applies to me a considerable degree, or a good part of time – OFTEN
3 Applies to me very much, or most of the time – ALMOST ALWAYS
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