Skip survey header

Irritability Assessment

Page One

This question requires a valid date format of MM/DD/YYYY.
calendar
Who is it who has asked you to fill out this form? - choose one
Experiences of violence
Space Cell How often do you have this experience? How severe is it? What are the worst consequences of it?
Physical altercations
Verbal outbursts or fights
Damaging property, car accidents
Describe situations, behaviors, emotions, and cognitions that may result in aggressive behavior.
GoalsHow often when you experienced aggressive behavior did you notice...
Space Cell Describe the frequency of this experience of violence or aggression.
The aggression was unplanned and without regard to consequences
The aggression was intended to achieve an objective
What kind of things happened as the result of violence or aggressiveness. For example, job loss, disruption of interpersonal relationships, hospitalization for injuries, legal charges, and incarceration.
HistoryWhen did you first start to notice violence or aggressive behavior? Since then has it been an ongoing issue or have there been periods without aggressive behavior?
Space Cell Discuss
When did you first start to notice violence or aggressive behavior?
Since then has it been an ongoing issue or have there been periods without aggressive behavior?
What have you tried to control the behavior?
Between episodes of aggressive or violent behavior how angry are you generally?