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Regence Questionnaires

Severity Ranges (by questionnaire)

Questionnaire Normal/Mild Distress (25%) Moderate Distress (50%) Severe Distress (25%)
ACORN-Adult 0-1.4 1.5-2.5 2.6-4
ACORN-Youth or Child-Self-report 0-1 1.1-1.8 1.9-4
ACORN-Youth or Child-Caregiver-report 0-1.2 1.3-9 2-4

Item List

  • GDS indicates item is included in the Global Distress Scale
    • Items are excluded from the GDS due to a high percentage of respondents reporting no problem and/or low a correlation between them item responses with the global distress factor

Adult Items

  • Symptoms
    • feel unhappy or sad? (GDS)
    • have little or no energy? (GDS)
    • worry about a lot of things? (GDS)
    • feel worthless? (GDS)
    • feel no interest in things? (GDS)
    • have a problem with eating (too much or too little)? (GDS)
    • have problems with sleep (too much or too little)? (GDS)
    • feel tense or nervous? (GDS)
    • cry easily? (GDS)
    • feel lonely? (GDS)
    • feel hopeless about the future? (GDS)
    • have a hard time controlling your temper? (GDS)
    • have a headache or pain in your body? (GDS)
    • feel irritated? (GDS)
    • feel bothered by pain? (GDS)
    • have physical pain or other health problems? (GDS)
    • feel fearful. (GDS)
    • worry about medical problems? (GDS)
    • I heard voices when I was alone.
    • feel good about yourself? (GDS)
  • Function (Work/School)
    • have a hard time paying attention? (GDS)
    • feel unproductive at work or other daily activities? (GDS)
    • find yourself daydreaming, worrying or staring into space? (GDS)
    • have trouble with your household chores? (GDS)
    • accomplish most of what you wanted to do? (GDS)
    • feel unable to complete your work or other daily tasks in a timely manner? (GDS)
  • Social
    • have a hard time getting along with family or friends? (GDS)
    • worry about family problems? (GDS)
    • make mistakes at work that caused problems? (GDS)
  • Substance Abuse
    • have someone express concerns about your alcohol or drug use?
    • feel the need to use alcohol or drugs?
    • feel sad or angry that you can't use alcohol or drugs like other people?
    • feel accepted by your recovery support group?
    • feel a need for a higher power in your life?
    • believe that the problems in your life have little to do with alcohol or drugs?
    • believe it is possible to use alcohol/drugs in a controlled way?
    • feel that you can handle stress in your life without using drugs or alcohol?
    • think of yourself as an alcoholic or addict?
    • participate in activities that support a clean and sober life style?
    • use alcohol or drugs?
  • Self Harm
    • think about harming yourself or others? (GDS)
    • have thoughts of ending your life? (GDS)

Youth&Child Items

  • Symptoms
    • eat a lot more or a lot less than usual? (GDS)
    • feel unhappy or sad? (GDS)
    • have a hard time controlling your temper? (GDS)
    • worry about a lot of things? (GDS)
    • feel worthless? (GDS)
    • have a hard time having fun? (GDS)
    • have a hard time sleeping because you were worried? (GDS)
    • cry easily? (GDS)
    • get mad? (GDS)
    • have aches, pains or other body problems? (GDS)
    • have a hard time falling or staying asleep? (GDS)
    • feel anxious, worried or fearful? (GDS)
    • have unusual eating habits?
    • have obsessive thoughts?
    • have toileting problems or bed-wetting?
  • Function (Work/School)
    • have a hard time waiting your turn? (GDS)
    • have a hard time paying attention? (GDS)
    • lose things you need? (GDS)
    • have a hard time sitting still? (GDS)
    • have a problem doing chores or schoolwork? (GDS)
    • show physical aggression?
    • exhibit obsessive behavior?
    • avoid going to school?
  • Social
    • get into trouble? (GDS)
    • disobey adults? (not do what adults told you to do) (GDS)
    • interrupt others? (GDS)
    • lie? (GDS)
    • lie to get things he/she wanted? (GDS)
    • have a hard time getting along with family and/or friends? (GDS)
    • hang out with kids who get into trouble? (GDS)
    • feel nervous and/or shy around other people? (GDS)
    • get into fights with family members and/or friends? (GDS)
    • annoy other people on purpose? (GDS)
    • argue with adults? (GDS)
    • think that you don't have any friends? (GDS)
    • get into trouble with family or friends? (GDS)
    • have no interest in friends or activities? (GDS)
  • Substance Abuse
    • drink alcohol (beer, wine, hard liquor)?
    • feel like drinking or drugging?
    • drink alcohol or use other substances?
  • Self Harm
    • feel like hurting yourself or somebody else? (GDS)
    • threaten or attempt self injury? (GDS)
  • Other
    • have any other problem not listed here? (GDS)
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