Profile of Mood States - Mills River Family Chiropractic

Profile of Mood States Subject's Initials Birth date Date Subject Code No.

Directions: Describe HOW YOU FEEL RIGHT NOW by circling the most appropriate number after each of the words listed below: Quite a

FEELING 1. Friendly 2. Tense 3. Angry 4. Worn Out 5. Unhappy 6. Clear-headed 7. Lively 8. Confused 9.

Sorry for things done

10. 11. 12. 13. 14. 15. 16.

Shaky Listless Peeved Considerate Sad Active On edge

17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28.

Grouchy Blue Energetic Panicky Hopeless Relaxed Unworthy Spiteful Sympathetic Uneasy Restless Unable to

29. Fatigued

Not at all

A little

Moderate

bit

Extremely

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30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55.

Helpful Annoyed Discouraged Resentful Nervous Lonely Miserable Muddled Cheerful Bitter Exhausted Anxious Ready to fight Good-natured Gloomy Desperate Sluggish Rebellious Helpless Weary Bewildered Alert Deceived Furious Effacious Trusting

56. 57. 58. 59. 60. 61. 62.

Full of pep Bad-tempered Worthless Forgetful Carefree Terrified Guilty

63. Vigorous 64. Uncertain about things

65. Bushed

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