Global Check Set

Name*

First NameLast Name

Date of Birth*

Date

Phone Number

Please enter a valid phone number.

Email

example@example.com

Sex*

MaleFemale

Instructions: Read through each statement respondings to items in a manner that best describes your experience over the most recent 2 weeks. Some questions relate to the present and some to the past, respond accordingly.

1-a. I drink alcoholic beverages daily*

2-d. I feel sad, empty, or become tearful*

3-s. I feel hopeless and worthless*

4-p. I have been exposed directly or indirectly (i.e., family, friend, colleagues) to a traumatic event*

5-x. I worry and feel anxious*

6-i. My body is usually pain free*

7-c. I cannot recall details of a trauma I experienced *

8-a. I use illegal drugs daily*

9-d. My sleep is disrupted or I am tired when I wake up*

10-s. I have a positive and cheerful attitude towards life*

11-p. Thoughts of a traumatic event keep coming to my mind (i.e., thoughts, dreams, flashbacks)*

12-x. I seem to be unable to control my worries or fears *

13-i. I worry about my health*

14-c. I do not know how I came to be at some place*

15-a. Drugs or alcohol interfere with what I need to get done *

16-d. I am no longer interested in the activities I used to enjoy*

17-s. I think about ending my life*

18-i. I have not been well due to a diagnosed physical illness(es)*

19-c. I easily recall important information about myself*

20-a. Drugs/alcohol have negatively impacted my life *

21-d. I have a lot of energy*

22-s. I have a specific plan to end my life *

23-p. I lose my temper easily*

24-x. I always feel on edge*

25-i. I have frequent headaches*

26-c. I act out of character and feel I don't know myself *

27-a. Drugs or alcohol are not a problem in my life *

28-d. I have lost or gained more than 10 lbs. recently*

29-s. I fear that my life will never improve*

30-p. I avoid people, places or things that are trauma reminders*

31-x. My concentration is good*

32-i. I am afraid that I will become seriously ill in the future*

33-c. I feel outside myself - detached like an observer *

34-p. I am fairly relaxed and do not startle easily*

35-x. I feel irritable most of the time*

(d) + (a) + (s) + (p)
+ (x) + (i) + (c) = Total GSC Score

Global Check Set (GCS): This scale was developed as a rapid check of multiple key areas of psychological wellnesss. There are no psychometric standards or official scoring norms for this scale and hence it is not to be used for diagnostic purposes. However, it is a useful tool to bring attention to potential problem areas for further investigation.

It covers seven areas which include:

Depression(d) (#2, 9, 16, 21, 28)

Substance Use(a) (# 1, 8, 15, 20, 27)

Suicidality(s) (# 3, 10, 17, 22, 29)

PTSD(p) (# 4, 11, 23, 30, 34)

Generalized Anxiety Disorder(x) (# 5, 12, 24, 31, 35)

Somatization(i) (# 6, 13, 18, 25, 32), and

Dissociation(c) (#7, 14, 19, 26, 33).

Scoring is achieved through a total sum of scores as listed on scaled items (Total GSC Score).

For greater clarification total the sub-scores of the subscales above (d, a, s, p, x, i, c). Higher Scores signify greater psychological distress - compare scores over time.

Scores of 6 or higher in any of the subscales require further investigation

Scores of 9 or higher suggest a noteworthy risk factor

Any elevations above 3 on the Suicidality scale will require closer examination

Higher Scores signify greater psychological distress - comparte scores over time. A Total Score of greater than or equal to > 70 = represents significant psychological distress.

Select your therapist*

Global Check Set

Global Check Set - Scoring