RCADS47 Youth Form

This service is only available within South Australia. Check our services page for specific locations. Or contact Head to Health directly on 1800 595 212 or visit website www.headtohealth.gov.au for alternative services in their area.

Please select the word that shows how often each of these things happens to you. There are no right or wrong answers.

NeverSometimesOftenAlways
I worry about things
Never
Sometimes
Often
Always
I feel sad or empty
Never
Sometimes
Often
Always
When I have a problem, I get a funny feeling in my stomach
Never
Sometimes
Often
Always
I worry when I think I have done poorly at something
Never
Sometimes
Often
Always
I would feel afraid of being on my own at home
Never
Sometimes
Often
Always
Nothing is much fun anymore
Never
Sometimes
Often
Always
I feel scared when I have to take a test
Never
Sometimes
Often
Always
I feel worried when I think someone is angry with me
Never
Sometimes
Often
Always
I worry about being away from my parents
Never
Sometimes
Often
Always
I get bothered by bad or silly thoughts or pictures in my mind
Never
Sometimes
Often
Always
I have trouble sleeping
Never
Sometimes
Often
Always
I worry that I will do badly at my school work
Never
Sometimes
Often
Always
I worry that something awful will happen to someone in my family
Never
Sometimes
Often
Always
I suddenly feel as if I can't breathe when there is no reason for this
Never
Sometimes
Often
Always
I have problems with my appetite
Never
Sometimes
Often
Always
I have to keep checking that I have done things right (like the switch is off, or the door is locked)
Never
Sometimes
Often
Always
I feel scared if I have to sleep on my own
Never
Sometimes
Often
Always
I have trouble going to school in the mornings because I feel nervous or afraid
Never
Sometimes
Often
Always
I have no energy for things
Never
Sometimes
Often
Always
I worry I might look foolish
Never
Sometimes
Often
Always
I am tired a lot
Never
Sometimes
Often
Always
I worry that bad things will happen to me
Never
Sometimes
Often
Always
I can't seem to get bad or silly thoughts out of my head
Never
Sometimes
Often
Always
When I have a problem, my heart beats really fast
Never
Sometimes
Often
Always
I cannot think clearly
Never
Sometimes
Often
Always
I suddenly start to tremble or shake when there is no reason for this
Never
Sometimes
Often
Always
I worry that something bad will happen to me
Never
Sometimes
Often
Always
When I have a problem, I feel shaky
Never
Sometimes
Often
Always
I feel worthless
Never
Sometimes
Often
Always
I worry about making mistakes
Never
Sometimes
Often
Always
I have to think of special thoughts (like numbers or words) to stop bad things from happening
Never
Sometimes
Often
Always
I worry what other people think of me
Never
Sometimes
Often
Always
I am afraid of being in crowded places (like shopping centers, the movies, buses, busy playgrounds)
Never
Sometimes
Often
Always
All of a sudden I feel really scared for no reason at all
Never
Sometimes
Often
Always
I worry about what is going to happen
Never
Sometimes
Often
Always
I suddenly become dizzy or faint when there is no reason for this
Never
Sometimes
Often
Always
I think about death
Never
Sometimes
Often
Always
I feel afraid if I have to talk in front of my class
Never
Sometimes
Often
Always
My heart suddenly starts to beat too quickly for no reason
Never
Sometimes
Often
Always
I feel like I don’t want to move
Never
Sometimes
Often
Always
I worry that I will suddenly get a scared feeling when there is nothing to be afraid of
Never
Sometimes
Often
Always
I have to do some things over and over again (like washing my hands, cleaning or putting things in a certain order)
Never
Sometimes
Often
Always
I feel afraid that I will make a fool of myself in front of people
Never
Sometimes
Often
Always
I have to do some things in just the right way to stop bad things from happening
Never
Sometimes
Often
Always
I worry when I go to bed at night
Never
Sometimes
Often
Always
I would feel scared if I had to stay away from home overnight
Never
Sometimes
Often
Always
I feel restless
Never
Sometimes
Often
Always

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