Stress Questionnaire

K6+ is a screening tool that helps to check for mental health problems in regular adults. It's designed to spot significant distress, and to tell apart cases of serious mental illness from others.

Personal Information

Your Name

Sex

Male Female

Date of Birth

Address

Assessment Test

The following questions ask about how you have been feeling during the past 30 days. For each question, select the number that best describes how often you had this feeling.
During the past 30 days, about how often did you feel nervous? None of the time A little of the time Some of the time Most of the time All of the time
During the past 30 days, about how often did you feel hopeless? None of the time A little of the time Some of the time Most of the time All of the time
During the past 30 days, about how often did you feel restless or fidgety? None of the time A little of the time Some of the time Most of the time All of the time
During the past 30 days, about how often did you feel so depressed that nothing could cheer you up? None of the time A little of the time Some of the time Most of the time All of the time
During the past 30 days, about how often did you feel that everything was an effort? None of the time A little of the time Some of the time Most of the time All of the time
During the past 30 days, about how often did you feel worthless? None of the time A little of the time Some of the time Most of the time All of the time

© Ronald C. Kessler, PhD. 2003
All rights reserved. Based on the Composite International Diagnostic Interview © 2001 Ronald C. Kessler, PhD. All rights reserved. Used with permission. Requests for permission to reproduce or translate — whether for sale or for noncommercial distribution should be addressed to Professor Ronald Kessler, PhD, Department of Health Care Policy, Harvard Medical School, (fax: +011 617-432-3588; email: [email protected])