180MW Marriage Assessment

Below is a list of problems that people sometimes have in response to a very stressful experience. Please read each problem carefully and then circle one of the options to indicate how much you have been bothered by that problem in the past month.

Demographic Information

Please take a moment to answer the following optional questions. Your answers are totally anonymous—we won’t be able to identify you based on this information. Your answers help us provide better information and support for people like you.

You can answer as many or as few questions as you would like. When you are done, scroll to the bottom of the survey and click “View Results” to receive your screening results.

About You