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Additional Addiction Assessment

Additional Addiction Related Survey

Brief Resilience Scale (BRS). Answer the following six questions related to resilience.

I tend to bounce back quickly after hard times(Required)
I have a hard time making it through stressful events.(Required)
It does not take me long to recover from a stressful event.(Required)
It is hard for me to snap back when something bad happens.(Required)
I usually come through difficult times with little trouble.(Required)
I tend to take a long time to get over set-backs in my life.(Required)

Please answer the following questions related to sexual behavior that may be problematic.

It’s alright for me to continue these behaviors.(Required)
Anyone can talk about wanting to do something about their behavior, but I am actually doing something about it.(Required)
Some of my sexual behaviors are problematic.(Required)
I should cut down on these behaviors.(Required)
I'm trying to cut back these behaviors.(Required)
My sexual behavior is okay as it is.(Required)

Please answer for the following substances or behaviors. I have or have had a problematic relationship with:

Alcohol -- in the past(Required)
Alcohol -- in the present or very recent past(Required)
Marijuana -- in the past(Required)
Marijuana -- in the present or very recent past(Required)
Illegal drugs -- in the past(Required)
Illegal drugs -- in the present or very recent past(Required)
Prescription drugs -- in the past(Required)
Prescription drugs -- in the present or very recent past(Required)
Smoking or vaping (non-cannibus) -- in the past(Required)
Smoking or vaping (non-cannibus) -- in the present or very recent past(Required)
Gambling -- in the past(Required)
Gambling -- in the present or very recent past(Required)
Video Games -- in the past(Required)
Video Games -- in the present or very recent past(Required)
Shopping -- in the past(Required)
Shopping -- in the present or very recent past(Required)
Food -- in the past(Required)
Food -- in the present or very recent past(Required)
Social Media or other non-sexual related internet activity -- in the past(Required)
Social Media or other non-sexual related internet activity -- in the present or very recent past(Required)

Answer the following based on what best represents you the last four weeks related to NON-SEXUAL use of the internet. Do not include pornography, profile browsing, or any sexual-related behaviors, and only answer as it relates to social media, email, news, etc.

Does your work suffer (e.g., postponing things, not meeting deadlines, etc.) because of the amount of time you spend online?(Required)
Do you block disturbing thoughts about your life with soothing thoughts of the Internet?(Required)
Do you feel preoccupied with the Internet when offline or fantasize about being online?(Required)
Do you find yourself saying “Just a few more minutes” when online?(Required)
Do you try to cut down the amount of time you spend online and fail?(Required)
Do you feel depressed, moody, or nervous when you are offline, which goes away once you are back online?(Required)
Review and uncheck if not applicable