Adult Symptom Screening Form by Leigh Silverton, Ph.D.

This convenient checklist helps structure and focus the diagnostic interview. Requiring just 10 to 15 minutes to complete, it lists more than 100 DSM-IV related symptoms in clear, easy-to-understand language. The client simply checks those symptoms that he or she has experienced. The symptoms listed relate to the following areas: cognitive difficulties, psychoactive substance use disorder, psychoses, mood disorders, phobias, obsessive-compulsive behavior, post-traumatic stress, somatoform and dissociative disturbances, sexual deviance, other sexual problems, impulse control difficulties, eating disturbance, and V-code problems involving partner relationships, occupational functioning, grief reactions, and parent-child interaction.

The client checks problems on the top sheet of the form, and these marks are automatically transferred to the bottom sheet, where they are aligned with corresponding clinical symptoms and associated diagnoses. When the form is separated, the bottom page serves as the clinician’s worksheet. It guides the initial interview, provides material for the intake report, and identifies areas where personality testing might be helpful.

Component

Problem Behavior Inventory (Pkgs. of 25)

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