|Acceptance and Action Questionnaire - 7 Item (AAQ-II-7)
| Gender: <.Patient_Gender.>
|
| AAQ-II-7 Total Score = <-Total->
| Higher scores equal greater levels of psychological inflexibility.
|
|Questions and Answers:
|
| 1. My painful experiences and memories make it difficult for me to
| live a life that I would value.
| <*Answer_9549*>
|
| 2. I'm afraid of my feelings.
| <*Answer_9550*>
| 3. I worry about not being able to control my worries and feelings.
| <*Answer_9551*>
| 4. My painful memories prevent me from having a fulfilling life.
| <*Answer_9552*>
| 5. Emotions cause problems in my life.
| <*Answer_9553*>
| 6. It seems like most people are handling their lives better than
| I am.
| Date Given: <.Date_Given.>
| <*Answer_9554*>
| 7. Worries get in the way of my success.
| <*Answer_9555*>
|
|Information contained in this note is based on a self-report assessment
|and is not sufficient to use alone for diagnostic purposes. Assessment
|results should be verified for accuracy and used in conjunction with
|other diagnostic activities.
| Clinician: <.Staff_Ordered_By.>
| Location: <.Location.>
|
| Veteran: <.Patient_Name_Last_First.>
| SSN: <.Patient_SSN.>
| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)
|
