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When you look at yourself in the mirror each morning, are you dissatisfied with
your appearance?
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Do you like your job and the people you work with? (if you like one but not the
other, answer “no”)
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When you think about your finances, do you feel worried, confused, or apprehensive
more than half the time?
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Do you have one or more people in your life that you feel you can trust?
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Do you believe that your family usually supports you in your goals, aspirations,
and personal choices?
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Do you ever feel that, with a little more support, your life would be more the way
you had hoped it would be?
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Do you ever feel guilty about spending money or time on your personal well-being?
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Is it common for you to consume sweets, caffeinated drinks, or alcohol, as rewards
for major or minor accomplishments?
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Do you often spend your leisure time in ways that you don’t consider fulfilling
(whether it be chores, errands, obligations, or relationships)?
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Do you often (more than twice a week) have trouble falling asleep right away because
of thoughts or concerns from the day?
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When you look back at your life so far, are there 3 or more important aspects that
you wish you could go back and change?
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Do you feel that caffeine, nicotine, sugar, or another substance helps you get through
the day (at least 3 days per week)?
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Do you usually have sufficient time to yourself each day to spend as you choose?
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Do you feel able to express yourself freely most of the time?
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Do you usually sleep well at night and wake up feeling rested in the morning?
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Are you a primary caregiver for a child, spouse, parent, or other person?
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Do you engage in some form of exercise, of any type, almost every day?
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Is your daily schedule usually unpredictable?
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Have you had any type of vacation or time off during the past year?
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Are you the major source of income for your household?
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