Psychosis/Schizophrenia Questionnaire Psychosis/Schizophrenia Questionnaire * Input number based on your choices: Never, Rarely, Sometimes, Often, Very often First Name Last Name Phone (###) ### #### Email * What triggers your hallucinations or delusions? * 1. Do you ever hear or see things that others cannot? Never Rarely Sometimes Often Very often 2. Do you struggle to trust that what you are thinking is real? Never Rarely Sometimes Often Very often 3. Do you get the sense that others are controlling your thoughts and emotions? Never Rarely Sometimes Often Very often 4. Do you struggle to keep up with daily living tasks such as showering, changing clothes, paying bills, cleaning, cooking, etc.? Never Rarely Sometimes Often Very often 5. Do you feel that you have powers that other people cannot understand or appreciate? Never Rarely Sometimes Often Very often 6. Do you find it difficult to organize or keep track of your thinking? Never Rarely Sometimes Often Very often 7. Do other people say that it is difficult for you to stay on subject or for them to understand you? Never Rarely Sometimes Often Very often 8. Are you struggling with maintaining social relationships, employment, and/or academic demands? Never Rarely Sometimes Often Very often 9. Do you feel that you are being tracked, followed, or watched at home or outside? Never Rarely Sometimes Often Very often 10. Do other people have a difficult time guessing your emotions by your facial expressions? Never Rarely Sometimes Often Very often Thank you!
