Client: Michael Raup Jr. (Michael Raup Jr.

)
DOB: 03/04/1991

Beck Depression Inventory

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I feel sad. (1)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I feel I have nothing to look forward to. (2)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• As I look back on my life, all I can see is a lot of failure. (2)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I don’t get any real satisfaction out of anything anymore. (2)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I don’t feel particularly guilty. (0)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I don’t feel I am being punished. (0)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I am disappointed in myself. (1)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I blame myself for everything bad that happens. (3)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I don’t have any thoughts of killing myself. (0)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I don’t cry any more than usual. (0)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I am slightly more irritated now than usual. (1)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I have lost most of my interest in other people. (2)

Completed on Sep 30, 2020 at 9:50pm. Page 1 of 2

Client: Michael Raup Jr. (Michael Raup Jr.)
DOB: 03/04/1991

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I put off making decisions more than I used to. (1)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I believe that I look ugly. (3)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• It takes an extra effort to get started at doing something. (1)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I wake up 1-2 hours earlier than usual and find it hard to get back to sleep. (2)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I don’t get more tired than usual. (0)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• My appetite is not as good as it used to be. (1)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.

(score 0 if you have been purposely trying to lose weight)

• I haven’t lost much weight, if any, lately. (0)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I am very worried about physical problems, and its hard to think of much else. (2)

Choose one statement from among the group of four statements in each question that best describes how you have
been feeling during the past few days.
• I am much less interested in sex now. (2)

Completed on Sep 30, 2020 at 9:50pm. Page 2 of 2