* 1. What gender are you?

* 2. Has anyone in your family been diagonsed with a mental illness? If yes, plese explain.

* 3. On average how much sleep do you get every night?

* 4. Have you ever experienced diminished interest or pleasure in all or almost all activities?

* 5. Have you ever had recurrent and persistant thoughts, impulses or images that cause increased anxiety or distress?

* 6. Do you have difficulty initiating projects, or doing things on your own? If so, please explain.

* 7. Have you experienced feelings of worthlessness or excessive or inappropriate guilt? If so, please explain how frequent.

* 8. Do you engage in repetitive behaviors or mental acts which you feel driven to perform? If yes, please explain.

* 9. Are you able to express disagreement with others, without fear of loss of support or approval?

* 10. What is your ethnicity?

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