Grief Questionnaire

Please answer the following questions. For multiple choice questions where only one answer is required, select the answer that describes what happens most often. If you have trouble selecting just one answer, please narrow it down to a couple of possible answers, and then select the one that applies to you the most or most often.

For questions where multiple answers are acceptable, please check as many as apply to your situation.

1) Memories of the person who died or left upset me greatly.
2) I think about this person so much that it's hard for me to do the things I normally do.
3) I feel I cannot accept the loss of the person who died or left.
4) I feel myself longing for the person who died or left.
5) I feel drawn to the places and things associated with the person who's gone.
6) I can't help feeling angry about his/her death or leaving.
7) I feel disbelief over what happened.
8) I feel stunned or dazed over what happened.
9) Ever since he/she died or left, it is hard for me to trust people.
10) Ever since he/she died or left, I feel as if I have lost the ability to care about other people or I feel distant from people I care about.
11) I feel lonely a great deal of the time ever since the loss.
12) I have pain in the same area of my body or have some of the same symptoms as the person who died.
13) I go out of my way to avoid reminders of the person who's gone.
14) I feel that life is empty without the person who died or left.
15) I hear the voice of the person who's no longer in my life speak to me.
16) I see the person who's gone stand before me.
17) I feel that it is unfair that I should live when this person died or left.
18) I feel bitter over this person's death or leaving.
19) I feel envious of others who have not lost someone close.


Be sure to click Submit Test to see your results!



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