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PIPS
This questionnaire asks different questions about you and how you think about things. Please rate how much you agree or disagree with each item. Rate each item based on how you usually are or how you usually think.
Completely Disagre Disagree e Disagree Somewha t Agree Somewh at Agree Completely Agree

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My mood changes very often and very quickly. I often act on my feelings or emotions without thinking of the consequences. If I get better (emotionally, mentally, or psychologically), people will not realize how hard my life has been. To get better (emotionally, mentally, or psychologically), I need to change things about me or the things I am doing. There is a person (or several people) who I trust and can rely on for support in tough times. My daily life has little or no structure. I have intense, chronic physical pain most or every day. I am usually able to manage my emotions without using drugs, alcohol, or medication. Emotionally, I am very stable and even keel. I am very careful and deliberate when I make decisions. If I get better (emotionally, mentally, or psychologically), it will mean that the person or people who hurt me cannot be held responsible for what they did. My problems are mostly due to other people. I have no one I can trust or rely on for support. My daily life is very unpredictable and chaotic. I cannot do the things I want to do in life because of physical pain. My emotions often overwhelm me unless I use drugs, alcohol, or medication.

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Date

Subid: _________________