Self-Rated (Level 1) DSM-5-TR - Cross-Cutting Symptom Measure— Child Age 11–17
The DSM-5-TR Level 1 Cross-Cutting Symptom Measure is a self-rated measure that assesses mental health domains that are important across psychiatric diagnoses. It is intended to help clinicians identify additional areas of inquiry that may have significant impact on the child’s treatment and prognosis. In addition, the measure may be used to track changes in the child’s symptom presentation over time.
This child-rated version of the measure consists of 25 questions that assess 12 psychiatric domains, including depression, anger, irritability, mania, anxiety, somatic symptoms, inattention, suicidal ideation/attempt, psychosis, sleep disturbance, repetitive thoughts and behaviors, and substance use. Each item asks the child, age 11–17, to rate how much (or how often) he or she has been bothered by the specific symptom during the past 2 weeks. The measure was found to be clinically useful and had good test & retest reliability in the DSM-5 Field Trials conducted in pediatric clinical samples across the United States.
APA-DSM5TR-LEVEL1 MEASURE CHILD AGE 11 TO 17
INSTRUCTIONS: The questions ask about things that might have bothered you. For each question, choose the number that best describes how much (or how often) you have been bothered by each problem during the past TWO (2) WEEKS.
Your trust and confidence are important to us. All the information gathered through this form will be treated with the utmost confidentiality. To ensure that MindWell by CML Well-being and Psychological Services remains a trustworthy partner in this journey towards supporting your mental health and well-being, we make every effort to comply fully with the existing laws and regulations that govern us.
Kindly read through the terms and conditions for your acceptance.
TERMS AND CONDITIONS:
In compliance with the Data Privacy Act (DPA) of 2012, you understand and agree that by providing your personal data, you are agreeing and giving your full consent to CML Well-being and Psychological Services to collect, store, access, and/or process any personal data you may provide herein, such as but not limited to your name, mobile number and email address, whether manually or electronically, for the period allowed under the applicable law and regulations, and solely for the purposes of your counseling. You acknowledge that the collection and processing of your personal data are necessary for such purposes. You are aware of your right to be informed, to access, to object, to erasure or blocking, to damages, to file a complaint, to rectify and to data portability, and you understand that there are procedures, conditions, and exceptions to be complied with in order to exercise or invoke such rights. All such information shall be purged from our records after the closure of your counseling services/engagement with us as prescribed by law.
By using this form, you accept the responsibility for and agree on the following:
INFORMED CONSENT: This survey questionnaire is a standardized psychological test which we have made available electronically and includes your informed consent prior completion, highlighting the following: