Name _________________________ Section ________________ Date ___________________
W E L L N E S S WO R K S H E E T 2 3
The General Well-Being Scale
For each question, choose the answer that best describes how you have felt and how things have been going
for you during the past month.
1. How have you been feeling in general?
5 _____ In excellent spirits
4 _____ In very good spirits
3 _____ In good spirits mostly
2 _____ Ive been up and down in spirits a lot
1 _____ In low spirits mostly
0 _____ In very low spirits
2. Have you been bothered by nervousness or your nerves?
0 _____ Extremely soto the point where I could not work or take care of things
1 _____ Very much so
2 _____ Quite a bit
3 _____ Someenough to bother me
4 _____ A little
5 _____ Not at all
3. Have you been in firm control of your behavior, thoughts, emotions, or feelings?
5 _____ Yes, definitely so
4 _____ Yes, for the most part
3 _____ Generally so
2 _____ Not too well
1 _____ No, and I am somewhat disturbed
0 _____ No, and I am very disturbed
4. Have you felt so sad, discouraged, hopeless, or had so many problems that you wondered if anything
was worthwhile?
0 _____ Extremely soto the point I have just about given up
1 _____ Very much so
2 _____ Quite a bit
3 _____ Someenough to bother me
4 _____ A little bit
5 _____ Not at all
(over)
Insel/Roth, Connect Core Concepts in Health, Twelfth Edition 2012 The McGraw-Hill Companies, Inc. Chapter 3
Insel/Roth, Connect Core Concepts in Health, Brief Twelfth Edition 2012 The McGraw-Hill Companies, Inc. Chapter 3
WELLNESS WORKSHEET 23 continued
5. Have you been under or felt you were under any strain, stress, or pressure?
0 _____ Yesalmost more than I could bear
1 _____ Yesquite a bit of pressure
2 _____ Yessome, more than usual
3 _____ Yessome, but about usual
4 _____ Yesa little
5 _____ Not at all
6. How happy, satisfied, or pleased have you been with your personal life?
5 _____ Extremely happycouldnt have been more satisfied or pleased
4 _____ Very happy
3 _____ Fairly happy
2 _____ Satisfiedpleased
1 _____ Somewhat dissatisfied
0 _____ Very dissatisfied
7. Have you had reason to wonder if you were losing your mind or losing control over the way you act,
talk, think, feel, or of your memory?
5 _____ Not at all
4 _____ Only a little
3 _____ Some, but not enough to be concerned
2 _____ Some, and Ive been a little concerned
1 _____ Some, and I am quite concerned
0 _____ Much, and Im very concerned
8. Have you been anxious, worried, or upset?
0 _____ Extremely soto the point of being sick, or almost sick
1 _____ Very much so
2 _____ Quite a bit
3 _____ Someenough to bother me
4 _____ A little bit
5 _____ Not at all
9. Have you been waking up fresh and rested?
5 _____ Every day
4 _____ Most every day
3 _____ Fairly often
2 _____ Less than half the time
1 _____ Rarely
0 _____ None of the time
(over)
WELLNESS WORKSHEET 23 continued
10. Have you been bothered by any illness, bodily disorder, pain, or fears about your health?
0 _____ All the time
1 _____ Most of the time
2 _____ A good bit of the time
3 _____ Some of the time
4 _____ A little of the time
5 _____ None of the time
11. Has your daily life been full of things that are interesting to you?
5 _____ All the time
4 _____ Most of the time
3 _____ A good bit of the time
2 _____ Some of the time
1 _____ A little of the time
0 _____ None of the time
12. Have you felt downhearted and blue?
0 _____ All the time
1 _____ Most of the time
2 _____ A good bit of the time
3 _____ Some of the time
4 _____ A little of the time
5 _____ None of the time
13. Have you been feeling emotionally stable and sure of yourself?
5 _____ All the time
4 _____ Most of the time
3 _____ A good bit of the time
2 _____ Some of the time
1 _____ A little of the time
0 _____ None of the time
(over)
Insel/Roth, Connect Core Concepts in Health, Twelfth Edition 2012 The McGraw-Hill Companies, Inc. Chapter 3
Insel/Roth, Connect Core Concepts in Health, Brief Twelfth Edition 2012 The McGraw-Hill Companies, Inc. Chapter 3
WELLNESS WORKSHEET 23 continued
14. Have you felt tired, worn out, used-up, or exhausted?
0 _____ All the time
1 _____ Most of the time
2 _____ A good bit of the time
3 _____ Some of the time
4 _____ A little of the time
5 _____ None of the time
Circle the number that seems closest to how you have felt generally during the past month.
15. How concerned or worried about your health have you been?
Not
concerned
at all
10
Very
concerned
Very
tense
10
Very
energetic,
dynamic
10
Very
cheerful
16. How relaxed or tense have you been?
Very
relaxed
10
17. How much energy, pep, and vitality have you felt?
No energy
at all,
listless
18. How depressed or cheerful have you been?
Very
depressed
Scoring
Add up all the points for the answers you have chosen, and find your score below.
81110
7680
7175
Positive well-being
Low positive
Marginal
5670
Stress problem
4155
2640
025
Distress
Serious
Severe
SOURCE: National Center for Health Statistics, General Well-Being Scale (GWBS).
