1. Work problems—behavior
1a Performance: As far as you know‚ how has S [the Subject] been coping with work? Does S have any difficulties? (Rate performance at work tasks.)
Not known; Not applicable‚ (0) no problems‚ (1) reduced output/given easier job‚ (2) unable to perform his job/others have taken over
1b Time keeping: Does S usually get to work on time?
Not known; Not applicable‚ (0) usually arrives at a reasonable time‚ (1) has occasionally missed 1⁄2–1 hour‚ or been more than 1 hour late‚ (2) has been more than 1 hour late on more than two occasions in last 4 weeks
1c Overactivity: Does S take on too much? (Is he rushed? Does he miss breaks or work late a lot?)
Not known; Not applicable‚ (0) does a day’s work but no more- work does not intrude on personal time‚ (1) rushes to complete jobs‚ on a tight schedule and/or occasionally works late or brings work home‚ (2) work frequently occupies evenings and weekends
Other problems (specify) ____________________________________
1. Rate work problems—behaviour
none ___________________________________________________________severe difficulties
2. Work problems—stress
Does S talk about work? Has S complained about work recently? Has S seemed upset about work or under strain because of work?
2a Interest and satisfaction: Does S say that he likes his work? Has S complained that he is bored or fed up with work?
Not known; Not applicable‚ (0) S seems reasonably satisfied with work situation‚ (1) S reports that he is disinterested or somewhat dissatisfied with work‚ (2) S indicates that he is utterly bored or dissatisfied with work
2b Distress: Does S seem to take work in his stride‚ or does work get him down? Does he appear troubled when he gets home from work? Does S complain that he has lost confidence? (Exclude boredom and dissatisfaction; include worry‚ strain‚ anxiety and anger).
Not known; Not applicable‚ (0) no noticeable discomfort due to work‚ (1) some degree of distress occasionally reported or observed‚ (2) S reports extreme distress or informant observes this most of the time
2c Work relationships—friction: Has S talked about other people at work? In general how does he get on with them? Has S mentioned any quarrels or friction recently? (Include overt interpersonal difficulty with both clients and colleagues regardless of degree of associated distress).
Not known; Not applicable‚ (0) generally‚ smooth easy relationships‚ (1) some friction or quarrelling during each week‚ (2) friction or quarrelling is a constant feature of work situation
2d Work relationships—exploitation: Has S complained that he is treated unfairly at work? Has he complained that he feels put upon or dominated?
Not known; Not applicable‚ (0) S reports no exploitation‚ (1) S reports occasional injustices or exploitation‚ (2) S complains of extreme exploitation
Other problems (specify) ____________________________________
1. Rate work problems—strees
none ___________________________________________________________severe difficulties
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