This survey is about thoughts. There are no right or wrong answers,
so please respond honestly to each of the items below. Be sure to answer
every item by circling the appropriate letter beside each.
A B C D E 1. There are things I prefer not
to think about.
A B C D E 2. Sometimes I wonder why I have
the thoughts I do.
A B C D E 3. I have thoughts that I cannot
A B C D E 4. There are images that come to
mind that I cannot erase.
A B C D E 5. My thoughts frequently return
to one idea.
A B C D E 6. I wish I could stop thinking
of certain things.
A B C D E 7. Sometimes my mind races so fast
I wish I could stop it.
A B C D E 8. I always try to put problems
out of mind.
A B C D E 9. There are thoughts that keep
jumping into my head.
A B C D E 10. There are things that I try
not to think about.
A B C D E 11. Sometimes I really wish I could
A B C D E 12. I often do things to distract
myself from my thoughts.
A B C D E 13. I have thoughts that I try
A B C D E 14. There are many thoughts that
I have that I don't tell anyone.
A B C D E 15. Sometimes I stay busy just
to keep thoughts from intruding on my mind.