(A-DES), Version 1.0

Judith Armstrong, Ph.D.,  Frank W. Putnam, M.D.,  Eve Bernstein Carlson, Ph.D.

 


DIRECTIONS

These questions ask about different kinds of experiences that happen to people.  For each question, circle the number that tells how much that experience happens to you.  Circle a “0" if it never happens to you, circle a “10" if it is always happening to you.  If it happens sometimes but not all of the time, circle a number between 1 and 9 that best describes how often it happens to you.  When you answer, only tell how much these things happen when you HAVE NOT had any alcohol or drugs.


 

 

1.         I get so wrapped up in watching TV, or playing video games, that I don’t have any idea what’s going on around me.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

2.         I get back tests or homework that I don’t remember doing.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

3.         I have strong feelings that don’t seem like they are mine.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

4.         I can do something really well one time and then I can’t do it at all another time.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

5.         People tell me I do or say things that I don’t remember doing or saying.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

6.         I feel like I am in a fog or spaced out and things around me seem unreal.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

 

7.         I get confused about whether I have done something or only thought about doing it.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

8.         I look at the clock and realize that time has gone by and I can’t remember what has happened.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

9.         I hear voices in my head that are not mine.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

10.       When I am somewhere that I don’t want to be, I can go away in my mind.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

11.       I am so good at lying and acting that I believe it myself.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

12.       I catch myself “waking up” in the middle of doing something.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

13.       I don’t recognize myself in the mirror.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

14.       I find myself going somewhere or doing something and I don’t know why.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

15.       I find myself someplace and don’t remember how I got there.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

16.       I have thoughts that don’t really seem to belong to me.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

17.       I find that I can make physical pain go away.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

18.       I can’t figure out if things really happened or if I only dreamed or thought about them.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

19.       I find myself doing something that I know is wrong, even when I really don’t want to do it.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

20.       People tell me that I sometimes act so differently that I seem like a different person.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

21.       It feels like there are walls inside of my head.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

22.       I find writings, drawings or letters that I must have done but I can’t remember doing.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

23.       Something inside of me seems to make me do things that I don’t want to do.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

24.       I find that I can’t tell whether I am just remembering something or if it is actually happening to me.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

25.       I find myself standing outside my body, watching myself as if I were another person.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

26.       My relationships with my family and friends change suddenly and I don’t know why.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

27.       I felt like my past is a puzzle and some of the pieces are missing.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

28.       I get so wrapped up in my toys or stuffed animals that they seem alive.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

29.       I feel like there are different people inside of me.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)

 

30.       My body feels as if it doesn’t belong to me.

0          1          2          3          4          5          6          7          8          9          10

(Never)                                                                                        (Always)