Here is a list of things that happen to people and that people think or feel . Read each sentence

carefully, and circle the one word (Never, Sometimes, Often, or Always) that tells about you best,especially in the last two weeks. THERE ARE NO RIGHT OR WRONG ANSWERS.

Often

Often

Often

Often

Often

Often

47 . I think bad things happen because of me.

Never

Sometimes

Often

48 .

I feel lonely.

Never

Sometimes

Often

Never Sometimes Often

Never Sometimes Often

~ .

I feel like I am stupid .

Never

Sometimes

Never Sometiin

Never Sometimes

Never Sometimes

Never Sometimes

Never Sometimes

Never Sometimes

Never Sometimes

Never Sometimes

Never Sometimes

41 .

I think that my life is bad.

Never

Sometimes

42.

I have trouble doing things.

Never

Sometimes

43 .

I feel that I am a bad person .

44 .

I wish I were dead .

45 . I have trouble sleeping .

Never

Sometimes

46 .

I feel no one loves me.

Never

Sometimes

49. My stomach hurts.

50 .

I feel like bad things happen to me.

52 .

53 .

I feel sorry for myself.

I think I do things badly.

54 .

I feel bad about what I do.

56.

I want to be alone.

57.

I feel like crying .

58 .

I feel sad.

59 .

I feel empty inside .

so .

I think my life will be bad.

Never Sometimes

Never Sometimes

Often

Often

Often

Often

Often

Often

Often

Often

Often

Often

Page 3 Total

3

Always,

Always

Always

Always

Always

Always

Always

Alwavs

Always

Always

Always

Alwavs

Alwavs

Alwavs

Always'

Alwavs

Always

Alwavs,

:1lways

Always

i7 . People make me mad.

68 . I think people bother me.

69.

I get mad at other people .

70 .

When I get mad, I stay mad.

61 . I think people try to cheat me.

62 .

I feel like screaming .

63 .

I think people are unfair to me.

I think people try to hurt me .

I think my Life is unfair.

People bully me.

71 .

When I get mad, I have trouble getting over it .

I think people try to control me.

73 .

I feel people try to put me down.

72 .

Here is a list of things that happen to people and that people think or feel . Read each sentence

carefully, and circle the one word (Never, Sometimes, Often, or Always) that tells about you best .

THERE ARE NO RIGHT OR WRONG ANSWERS.

74 . I feel mean .

~5 . I feel like exploding .

76 .

I think people are against me.

79 .

I hate people .

80 .

I get mad.

77 . I get angry.

78 . When I get mad, I feel mad inside my body.

Page 4 Total

0 1 2 3

Never Sometimes Often Always

Never Sam~t`rnies Often Always

Never Sometimes Often Always

Never Sometimes Often Always

hTever Sometimes Often Always

Never Sometimes Often Always

1rVever Sometimes Often Always

Never Sometimes Often Always

Never Sometimes Often Always

Never Sometimes Often Always

Never Sometimes Often Always

Never Sometimes Often :~Iways

Never Sometimes Often :1lways

Never S~nnctimes Often Alwways

Never Sometimes Often Always , ;,

Never Sometimes Often Always

Never Sometimes Often , Always

Never Sometimes Often Always

Never Sometimes Often Always

Never Sometimes Often Always

Here is a list of things that happen to people and that people think or feel . Read each sentencecarefully, and circle the one word (Never, Sometimes, Often, or Always) that tells about you best.THERE ARE NO RIGHT OR WRONG ANSWERS.

82 .

Other people get me into trouble .

Never

Sometimes

Often

83 . I think about running away from home.

Never

Sometimes

Often

Atwavs

Always

84.

I do mean things__,_ �_b .

_, , . __. .

_, ._ ._.~

______n.

.._

_. . . .

Never

Sometimes

85 .

I break into cars, houses, or other places .

Never

Sometimes

Often

86 .

I fight with others .

Never

Sometimes

Often

87, I like getting people mad.

Never

Sometimes

Often

88. I skip school .

Never

'Sometimes

Often

89 .

I hate listening to other people .

Never

Sometimes

Often

90 . I argue with adults .

Never

,Sometimes

Often

91.

I hurt people .

92 .

I like being mean to others .

93 .

I break the rules .

95 .

I like to hurt animals .

96.

I like to bully others .

97.

I tell lies .

98 .

I like to trick people .

Often

Never Sometimes Often

94 .

I like it when people are scared of me.

Never

Sometimes

"

Often

Never Sometimes Often

Ne~"er Sometimes Often

Never Sometimes Often

Never Sometimes Often

99 . I break things when I am mad.

Never

Sometimes

Often

100. I swear at adults .

Never

Sometimes

Often

Page 5 Total

Always

Always

Alw ys

Always

Always

Always

_ Always

Always

Always

Always

Alway~t~°

Always

Always

Always

Always

Always

1=or Office Use Only After All Testing is Complete

When this booklet is returned, please make sure that all items are completed. Scoring instructions are given below.For more detailed instructions, refer to the Beck Youth InventoriesT"" (BYI) manual .

1 . Add the responses for all 20 items on each page .Record this number in the Page Total box located atthe bottom right-hand corner of each page. Do thisfor all five pages.

2. Transfer each Page Total to the Raw Score box (RS)below labeled with the matching page number. Eachbox corresponds to one of the five inventories(see acronyms below) .

T Score

100+

95

90

85

80

75

70

65

60

55

50

45

40

35

Name:

Date:

Sex:

D Female

~ Male

Age:

Grade:

Referred by :

Reason for Referral :

Treatment Status

Education Status

Intake : ~

School :

Review : ~

Teacher:

Grade:

Other :

I Comments :

~ ~ Comments :

Testing Observation :

Testing Results

Elevated Scores :

Critical Items :

Recommended Action :

Assessment Information

THEPSYCHOLOGICALCORPORATION®

Copyright © 2001 by The Psychological Corporation, a Harcourt Assessment Company. All rights reserved . No part of thisA Horcourt Assessment Company

publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy,recording, or any information storage and retrieval system, without permission in writing from the publisher. Printed in

To order, call 7-800-872-1726

the United States of America .

Please read instructions at the top of each inside page .

ID :

ParentlGuardian Name:

Notes:

PS

H

YCHOLOGICALCORPORATION®

A Harcourt Assessment Company

To order, call 1-800-872-1726

TM

Combination Booklet

,ground In

Date of Birth :

Copyright © 2001 by The Psychological Corporation, a Harcourt Assessment Company.

All rights reserved . No part of this publication may be reproduced or transmitted in anyform or by any means, electronic or mechanical, including photocopy, recording, or anyinformation storage and retrieval system, without permission in writing from the publisher

.

Printed in the United States of America .123456789101112ABCDE

9

ISBN 015401442-7

n780154

n014429

Name :

Today's Date : Location :

Sex: ~ Female ~ Male Grade:

Here is a list of things that happen to people and that people think or feel . Read each sentencecarefully, and circle the one word (Never, Sometimes, Often, or Always) that tells about you best .THERE ARE NO RIGHT OR WRONG ANSWERS.

3

Always=

Always

Always;

Always

Always

Al~~y&_

Always ;

Always

Always

Always,

Always

Always

Always

Aiwa

Always

Always

Always

Always

Page 1 Total

~ . People want to be with me. Never Sometimes often

5. I am just as good as the other kids . Never Sometimes Often

G. I feel normal . Never Sometimes Ofterti

7. I am a good person . Never Sometimes Often

~. I do things well . Never Sometimes Often

~, I can do things without help. Never Satnetimes Ufteu

10 . I feel smart. Never Sometimes Often

1'1 . People think I'm good at things. Never Sometimes Often

12 . I am kind to others . Never Sometimes Often

13 . I feel like a nice person . Never Sometimes t)ften

14 . I am good at telling jokes. Never Sometunes Often

15 . I am good at remembering things. Never Sometimes Often

16. I tell the truth. Never Sometimes {)ften

17. I feel proud of the things I do . Never Sometimes (}ften

21 . I worry someone might hurt me at school .

Here is a list of things that happen to people and that people think or feel . Read each sentencecarefully, and circle the one word (Never, Sometimes, Often, or Always) that tells about you best,especially in the last two weeks. THERE ARE NO RIGHT OR WRONG ANSWERS.

My dreams scare me.

I worry when I am at school .

I think about scary things.24,

25 .

26 .

I am afraid that I will make mistakes .

I worry people might tease me.

27 .

I get nervous .

28.

I am afraid I might get hurt .

29 .

I worry I might get bad grades .

30:

I worry about the future .

31 . My hands shake .

32. I worry I might go crazy.

34 .

I worry I might lose control.

35 .

Iworry.

36 . I have problems sleeping .

37 . My heart pounds .

39 . I am afraid that something bad might happen to me.

40.

I am afraid that I might get sick .

0

Never

Never

Never

Nei~er

N7ever

Never

Never

Never

Never

Never

l\Te~.er

Ne:~~er

Never

Never

Never

Never

Never

Never

Never

Never

3

Always

Sometimes Often Alwati~s

Sometimes Oftenv Always

Sometimes Often Always

Sonieti~aes Often' Always

Sometimes Often Always

Sometimes Often Always

Sometimes Often Always

Sometimes Often Always

Sometimes Often AUvays

Sometimes Often ways

Sarraeti~es Often Always

Sometimes Often Alwavs

Sornetiames Often Always

Sometimes ' Often Always

Sometimes Often Always

Sometimes Often Always

Sometimes Often Always

Sometimes Often Alwavs

Sometimes Often Alwavs