Somatoform Dissociation Questionnaire, SDQ Test - the question form
Questions: 20 · 4 minutes
1. I have problems with urination.
1 – Does not apply to me at all
2 – Applies to me just a little
3 – Applies to me to a moderate degree
4 – Applies to me somewhat
5 – Applies to me very much
2. I do not like tastes that I usually like (except for women during pregnancy or during menstruation).
1 – Does not apply to me at all
2 – Applies to me very slightly
3 – Applies to me moderately
4 – Applies to me slightly
5 – Applies to me very strongly
3. I hear sounds from sources close to me as if they were far away.
1 – Does not apply to me at all
2 – Applies to me only a little
3 – Applies to me moderately
4 – Applies to me somewhat
5 – Applies to me very much
4. I have pain when urinating.
1 – Does not apply to me at all
2 – Applies to me very slightly
3 – Applies to me to a moderate degree
4 – Applies to me slightly
5 – Applies to me very much
5. I feel numbness in my body or in part of my body.
1 – Does not apply to me at all
2 – Applies to me a little
3 – Applies to me moderately
4 – Applies to me somewhat
5 – Applies to me very much
6. People and things look bigger than usual.
1 – Does not apply to me at all
2 – Applies to me very slightly
3 – Applies to me moderately
4 – Applies to me slightly
5 – Applies to me very strongly
7. I have seizures that resemble epileptic seizures.
1 – Does not apply to me at all
2 – Applies to me very little
3 – Applies to me moderately
4 – Applies to me a little
5 – Applies to me very much
8. My body (or a part of my body) does not feel pain.
1 – Does not apply to me at all
2 – Applies to me just a little
3 – Applies to me to a moderate degree
4 – Applies to me somewhat
5 – Applies to me very much
9. I dislike smells that I usually like.
1 – Does not apply to me at all
2 – Applies to me very little
3 – Applies to me moderately
4 – Applies to me slightly
5 – Applies to me very strongly
10. I feel pain in my genital area (not during sexual intercourse).
1 – Does not apply to me at all
2 – Applies to me very slightly
3 – Applies to me to a moderate degree
4 – Applies to me a little
5 – Applies to me very strongly
11. At times I cannot hear (as if I were deaf).
1 – Not at all
2 – A little
3 – Moderately
4 – Quite a bit
5 – Very much
12. At times, I cannot see (as if I were blind).
1 – Does not apply to me at all
2 – Applies to me a little
3 – Applies to me moderately
4 – Applies to me somewhat
5 – Applies to me very much
13. I see things around me differently than usual (for example, as if looking through a tunnel or seeing only part of an object).
1 – Does not apply to me at all
2 – Applies to me very slightly
3 – Applies to me moderately
4 – Applies to me slightly
5 – Applies to me very strongly
14. My ability to smell is better or worse (when I am not ill).
1 – Does not apply to me at all
2 – Applies to me very slightly
3 – Applies to me moderately
4 – Applies to me slightly
5 – Applies to me very strongly
15. As if my body, or part of my body, had disappeared.
1 – Not at all
2 – Applies to me just a little
3 – Applies to me to a moderate degree
4 – Applies to me a little
5 – Applies to me very much
16. I cannot swallow, or I swallow only with great effort.
1 – Does not apply to me at all
2 – Applies to me very little
3 – Applies to me to a moderate degree
4 – Applies to me slightly
5 – Applies to me very strongly
17. I can go without sleep at night and still be very active during the day.
1 – Not at all true for me
2 – Slightly true for me
3 – Moderately true for me
4 – Somewhat true for me
5 – Very true for me
18. I cannot speak (or can speak only with great effort), or I can only whisper.
1 – Does not apply to me at all
2 – Applies to me very slightly
3 – Applies to me moderately
4 – Applies to me somewhat
5 – Applies to me very strongly
19. At times, I become paralyzed.
1 – Does not apply to me at all
2 – Applies to me just a little
3 – Applies to me to a moderate degree
4 – Applies to me somewhat
5 – Applies to me very strongly
20. At times, I freeze.
1 – Does not apply to me at all
2 – Applies to me very little
3 – Applies to me to a moderate degree
4 – Applies to me a little
5 – Applies to me very much