Read Dr. Dukarm's new book, Pieces of a Puzzle: The Link Between Eating Disorders and ADD. Click here to view the table of contents, read an excerpt, and order your copy.

Patient SELF-TESTS

Although these short tests are not intended to take the place of a comprehensive medical evaluation and diagnosis, they will help you recognize the signs and symptoms of eating disorders and ADD. You may wish to print this page and share the results of the tests with your healthcare professional during your next appointment. An accurate diagnosis can only be made through a clinical evaluation.

 

Eating Disorders: Self-Screening Survey

  1. Have you intentionally lost weight during the past six months? Yes/No
  2. Do you eat in secret? Yes/No
  3. Do you restrict how much, what, or when you eat on a consistent basis? Yes/No
  4. Do you ever exercise more than once a day or for more than two hours at a time during a workout? Yes/No
  5. Have you ever forced yourself to throw up after you feel you've eaten too much? Yes/No
  6. Do you ever feel guilty, anxious, or depressed about eating? Yes/No
  7. Do you hide how much or how little you eat from friends or family members? Yes/No
  8. Have you ever used laxatives to lose weight? Yes/No
  9. Do you eat "normally" in public but binge eat when you are alone? Yes/No
  10. Do you think about how much, what, or when you are going to eat even when you're not hungry or when it's not mealtime? Yes/No
  11. Have your menstrual periods become irregular of stopped? Yes/No

If you answered "yes" to more than a few questions, you may have an eating disorder or be at risk for developing an eating disorder. It may be beneficial for you to talk with your healthcare provider about an evaluation for an eating disorder.

 

Adult ADD: Self-Test

The following questionnaire can be used as a starting point to help you recognize the signs and symptoms of Adult ADD, but is not meant to replace consultation with a trained healthcare professional. An accurate diagnosis can only be made through a clinical evaluation. Regardless of the questionnaire results, if you have concerns about diagnosis and treatment of ADD, please discuss your concerns with your physician. This Adult Self-Report Scale (ASRS) is intended for people age 18 years or older.

Circle the number that best describes how you have felt and conducted yourself over the past six months.

0 = Never     1= Rarely     2 = Sometimes     3 = Often     4 = Very Often

A score of 11 points or higher indicates that your symptoms may be consistent with Adult ADD. It may be beneficial for you to talk with your healthcare provider about an evaluation for ADD.

This screening test is a subset of the World Health Organization's 18-question Adult ADHD Self-Report Scale Symptoms Checklist. Copyright 2003, World Health Organization, used with permission.

 

How to use the results of these self-tests

Because you have taken the time to access this website and answer the foregoing questions, it would appear that either you are aware or suspect you have issues with eating and/or attention. Therefore, you may wish to find out more about our program and/or talk to your healthcare provider about these issues.

About our program

 
Center for Eating Disorders, LLC
2157 Main Street
Buffalo, NY 14214
(716) 862-1611
info@carolyndukarmmd.com