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APPENDIX IV

Index of emotional well-being and mental health [Modified]

Part I: Use the list below to answer the following question:
  In general, how happy do you usually feel?
Check in one statement below that best describes your average happiness
Check any one of the boxes.
 
58
 
5   Very happy (feeling really good, joyous, elated)    
 
4   Happy (feeling fairly good and somewhat cheerful)    
 
3   Neutral (not particularly happy or unhappy)    
 
2   Unhappy (feeling low spirits, somewhat "blue")    
 
1   Very unhappy (feeling depressed, low spirits)    

Part II: Consider you emotions a moment further.    

On the average, what per cent of the time do you feel happy? What per cent of the time do you feel unhappy? What per cent of the time do you feel neutral(neither happy or unhappy)

Write down your best estimates, as well as you can in the spaces below. Make sure the three figures add up to equal 100%.

ON THE AVERAGE:

The per cent of time I feel happy ............... %
   
59-60
The per cent of time I feel unhappy ............... %
   
61-62
The per cent of time I feel neutral ............... %
   
63-64
Total 100%    

Name ...................................................................................  Sex ...............    Age .........

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