1. Do you ever have daydreams or thoughts about physically hurting or injuring some other persons?
2. When was the last time you had such a daydream or thought?
Longer than two months ago
3. How often have you had these daydreams or thoughts in the past two months?
A few times a month (less than once a week)
Two or three times in the past month
About once in the past two months
4. When did you start having these daydreams or thoughts?
During the past 1-3 months
During the past 3-6 months
During the past 6-12 months
5. When you have these daydreams or thoughts, are they usually about the same each time you have them, or do you imagine all kinds of different ways of hurting someone?
6. Are they usually about the same person, or might they be about many different people?
7. Since the time you first started having these thoughts, have the injuries that you think about gotten more serious, less serious, or have they been about the same?
8. In the past two months, have you ever had these thoughts while actually being with or watching the person whom you imagine hurting?
The presented answer sheet is not an original form and is not intended for printing or use as a handout.