0
1
2 3 4
5
Answer each statement by checking the appropriate box. The
"0" column means the statement does not apply to you . . . . and
"5" means that it strongly
1.
You
have frequent dizzy spells.
2.
You have notable periods (years, months, or days) of memory loss.
3.
You experience periodic seizures.
4.
You have frequent headaches.
5.
You are very creative especially in art, music, writing, or drama.
6.
Your personality changes with a yawn, cough, sneeze, twitch, or other movement.
7.
You have suicidal episodes wishing that you were dead.
8.
You
have compulsive feelings to communicate, but are fearful to do so.
Remember . . . it is only a test.
9.
You
have inflicted personal injury upon yourself through cutting or burning.
10.
You
have frequent panic attacks.
11.
You
have episodes of sadness without a conscious cause.
12.
You
are conscious of internal dialogue.
13.
You
are generally passive to controlling personalities.
14.
You
have a mysterious interest in or fear of the occult or satanism.
15.
You
experience sudden anger without a justified cause.
16.
You
have knowledge of the occult without book knowledge.
You are making good progress.
17.
You
have great difficulty in choosing what clothing to wear.
18.
You
have a strong desire to please or be accepted at the expense of personal
morals.
19.
You
have seemingly unshakable addictions (drugs, tobacco, food, or sex).
20.
You
have frequent stomach ailments.
21.
You
have an inability to remember recent or past actions which others point
out.
22.
You
feel extreme isolation even at social gatherings.
23.
You
struggle with eating disorders such as anorexia or bulimia.
24.
You
have bodily pain or extreme discomfort without known medical cause.
Don't stop now.
25.
You
sometime find yourself playing the role of your opposite sex.
26.
You
become depressed when being around children of a certain age.
27.
You
are fearful of being alone especially in dark places.
28.
You
feel extremely uncomfortable with communion (Lord's Supper) at church.
29.
You
generally avoid most all of physical contact.
30.
You
have major trust issues.
31.
You
experience feelings of detachment from reality in real life situations.
32.
You
discover yourself acting the extreme opposite of your normal personality.
You are past the halfway point.
33.
You become very distressed when religious topics are discussed.
34.
You have feelings frustration without a known cause.
35.
You are generally fearful of giving or receiving in intimacy (even in marriage).
36.
You often feel that you are being misunderstood.
37.
You experience personality changes when the topic of pregnancy is discussed.
38.
You experience extreme discomfort at the time of church altar calls.
39.
You
have feelings of detachment even when helping others.
40.
You are short or secretive about your personal life without explanation.
Keep up the good work.
41.
You have suffered from one or more traumatic sexual experiences.
42.
You
find yourself acting or thinking as a young child, yet in an adult body.
43.
You
excel in intelligence in one area, but fail miserably in many other areas.
44.
You
have been raised in or have been a member of an cult or occult.
45.
You
find yourself strongly wishing that you were another person.
46.
You
often wrestle with confusion about who you really are.
47.
You have nightmares or sleep disturbances.
48.
You
find that you have purchased items which you don't remember buying.
You have only one more set.
49.
You
have pictorial (visual) memories, but can place them mentally.
50.
You
have been raised in a extreme legalistic religious environment.
51.
You
may find yourself some place, but don't remember how you got there.
52.
You
find it difficult being still and fidget a lot.
53.
You
have had major losses such as through the deaths of those who you loved.
54.
You
seem to hear voices when no one else is around.
55.
You
find yourself daydreaming when you should be paying attention.
56.
You
were severely punished by your parents for not being perfect.
Congratulations! You have
finished.
.