{"id":6125,"date":"2025-10-31T12:57:39","date_gmt":"2025-10-31T12:57:39","guid":{"rendered":"https:\/\/mysoulspace.net\/?page_id=6125"},"modified":"2025-10-31T12:57:39","modified_gmt":"2025-10-31T12:57:39","slug":"ham-a","status":"publish","type":"page","link":"https:\/\/mysoulspace.net\/en\/ham-a\/","title":{"rendered":"HAM-A"},"content":{"rendered":"<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_4_container\" data-token=\"e8eb3712fe0d7c729a12bfff90f12039\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_js_validate  frm_ajax_submit  frm_pro_form \" id=\"form_pr89i\" data-token=\"e8eb3712fe0d7c729a12bfff90f12039\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">HAM-A<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"4\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_4\" id=\"frm_hide_fields_4\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"pr89i\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_4\" name=\"frm_submit_entry_4\" value=\"e667075ada\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/en\/wp-json\/wp\/v2\/pages\/6125\" \/><div id=\"frm_field_323_container\" class=\"frm_form_field  frm_html_container form-field\">\n<h3 style=\"text-align: center;\"><strong>Hamilton Anxiety Rating Scale (HAM-A)<\/strong><\/h3>\n<p style=\"text-align: center;\">The scale includes 14 graded symptoms, the total of which provides a general measure of the level of anxiety.<br \/>It is usually administered before starting treatment and then applied periodically to assess the degree of improvement.<\/p>\n<p style=\"text-align: center;\"><span style=\"color: #ff0000;\">Please choose the symptom description that most accurately reflects your condition.<\/span><\/p>\n<\/div>\n<div id=\"frm_field_67_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first\">\r\n\t<label for=\"field_fgf17\" id=\"field_fgf17_label\" class=\"frm_primary_label\">code\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/label>\r\n\t<input  type=\"text\" id=\"field_fgf17\" name=\"item_meta[67]\" value=\"4\"  readonly=\"readonly\"  data-frmval=\"4\" data-reqmsg=\"code cannot be blank.\" aria-required=\"true\" data-invmsg=\"code is invalid\" aria-invalid=\"false\"   \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_671_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\n\t<label for=\"field_f6l02\" id=\"field_f6l02_label\" class=\"frm_primary_label\">Email\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n\t<\/label>\n\t<input type=\"email\" id=\"field_f6l02\" name=\"item_meta[671]\" value=\"\"  autocomplete=\"email\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_672_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\n\t<label for=\"field_8uiwz\" id=\"field_8uiwz_label\" class=\"frm_primary_label\">Gender\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n\t<\/label>\n\t\t\t<select name=\"item_meta[672]\" id=\"field_8uiwz\"  data-frmval=\"Male\" data-reqmsg=\"Gender cannot be blank.\" aria-required=\"true\" data-invmsg=\"Gender is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Male\" selected='selected'>Male<\/option><option  value=\"Female\">Female<\/option>\t<\/select>\n\t\n\t\n\t\n<\/div>\n<div id=\"frm_field_673_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4 frm_first\">\n\t<label for=\"field_8dqws\" id=\"field_8dqws_label\" class=\"frm_primary_label\">Date of Birth \n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_8dqws\" name=\"item_meta[673]\" value=\"\"  maxlength=\"10\" data-reqmsg=\"Date of Birth  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date of Birth  is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_674_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\n\t<label for=\"field_irn3g\" id=\"field_irn3g_label\" class=\"frm_primary_label\">Marital Status\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n\t<\/label>\n\t\t\t<select name=\"item_meta[674]\" id=\"field_irn3g\"  data-frmval=\"Married\" data-reqmsg=\"Marital Status cannot be blank.\" aria-required=\"true\" data-invmsg=\"Marital Status is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Married\" selected='selected'>Married<\/option><option  value=\"Single\">Single<\/option><option  value=\"Widowed\">Widowed<\/option><option  value=\"Divorced\">Divorced<\/option>\t<\/select>\n\t\n\t\n\t\n<\/div>\n<div id=\"frm_field_675_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm4\">\n\t<label for=\"field_s99p2\" id=\"field_s99p2_label\" class=\"frm_primary_label\">Educational level\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\n\t<\/label>\n\t\t\t<select name=\"item_meta[675]\" id=\"field_s99p2\"  data-frmval=\"Primary\" data-reqmsg=\"Educational level cannot be blank.\" aria-required=\"true\" data-invmsg=\"Educational level is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"Primary\" selected='selected'>Primary<\/option><option  value=\"Secondary\">Secondary<\/option><option  value=\"University\">University<\/option><option  value=\"Postgraduate\">Postgraduate<\/option>\t<\/select>\n\t\n\t\n\t\n<\/div>\n\t\t<input  type=\"hidden\" name=\"item_meta[69]\" id=\"field_z4pdg\" value=\"09\/21\/2026\"  data-frmval=\"09\/21\/2026\"   \/>\n\t\t<div id=\"frm_field_70_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_85sdw_label\" class=\"frm_primary_label\">1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_85sdw_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_70-0\">\t\t\t<label  for=\"field_85sdw-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[70]\" id=\"field_85sdw-0\" value=\"0\"\n\t\t data-reqmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood cannot be blank.\" data-invmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_70-1\">\t\t\t<label  for=\"field_85sdw-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[70]\" id=\"field_85sdw-1\" value=\"1\"\n\t\t data-reqmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood cannot be blank.\" data-invmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood is invalid\"   \/> Occasional worry or mild tension, generally manageable<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_70-2\">\t\t\t<label  for=\"field_85sdw-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[70]\" id=\"field_85sdw-2\" value=\"2\"\n\t\t data-reqmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood cannot be blank.\" data-invmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood is invalid\"   \/> Frequent anxious thoughts, noticeable unease most of the day<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_70-3\">\t\t\t<label  for=\"field_85sdw-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[70]\" id=\"field_85sdw-3\" value=\"3\"\n\t\t data-reqmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood cannot be blank.\" data-invmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood is invalid\"   \/> Persistent fear or apprehension throughout most of the day<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_70-4\">\t\t\t<label  for=\"field_85sdw-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[70]\" id=\"field_85sdw-4\" value=\"4\"\n\t\t data-reqmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood cannot be blank.\" data-invmsg=\"1. Anticipation of the worst or frightening events, apprehension and suspicion, irritability, and dysphoric mood is invalid\"   \/> Constant anxiety, overwhelming dread or panic interfering with function<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_71_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_2s39e_label\" class=\"frm_primary_label\">2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_2s39e_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_71-0\">\t\t\t<label  for=\"field_2s39e-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[71]\" id=\"field_2s39e-0\" value=\"0\"\n\t\t data-reqmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying cannot be blank.\" data-invmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_71-1\">\t\t\t<label  for=\"field_2s39e-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[71]\" id=\"field_2s39e-1\" value=\"1\"\n\t\t data-reqmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying cannot be blank.\" data-invmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying is invalid\"   \/> Slight nervous tension, occasional restlessness<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_71-2\">\t\t\t<label  for=\"field_2s39e-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[71]\" id=\"field_2s39e-2\" value=\"2\"\n\t\t data-reqmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying cannot be blank.\" data-invmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying is invalid\"   \/> Frequent episodes of uneasiness, noticeable difficulty relaxing<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_71-3\">\t\t\t<label  for=\"field_2s39e-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[71]\" id=\"field_2s39e-3\" value=\"3\"\n\t\t data-reqmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying cannot be blank.\" data-invmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying is invalid\"   \/> Continuous inner tension, marked restlessness or trembling<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_71-4\">\t\t\t<label  for=\"field_2s39e-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[71]\" id=\"field_2s39e-4\" value=\"4\"\n\t\t data-reqmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying cannot be blank.\" data-invmsg=\"2. Tension \u2014 fatigue, panic feelings, restlessness, inability to relax, emotional instability, or easy crying is invalid\"   \/> Near-constant agitation, unable to stay calm or composed<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_72_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_wz2rg_label\" class=\"frm_primary_label\">3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_wz2rg_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_72-0\">\t\t\t<label  for=\"field_wz2rg-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[72]\" id=\"field_wz2rg-0\" value=\"0\"\n\t\t data-reqmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic cannot be blank.\" data-invmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_72-1\">\t\t\t<label  for=\"field_wz2rg-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[72]\" id=\"field_wz2rg-1\" value=\"1\"\n\t\t data-reqmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic cannot be blank.\" data-invmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic is invalid\"   \/> Occasional mild fears in specific situations<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_72-2\">\t\t\t<label  for=\"field_wz2rg-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[72]\" id=\"field_wz2rg-2\" value=\"2\"\n\t\t data-reqmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic cannot be blank.\" data-invmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic is invalid\"   \/> Recurrent fears causing discomfort or avoidance<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_72-3\">\t\t\t<label  for=\"field_wz2rg-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[72]\" id=\"field_wz2rg-3\" value=\"3\"\n\t\t data-reqmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic cannot be blank.\" data-invmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic is invalid\"   \/> Persistent fears limiting daily functioning<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_72-4\">\t\t\t<label  for=\"field_wz2rg-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[72]\" id=\"field_wz2rg-4\" value=\"4\"\n\t\t data-reqmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic cannot be blank.\" data-invmsg=\"3. Fears \u2014 of darkness, strangers, being alone, animals, crowds, or traffic is invalid\"   \/> Incapacitating fear or panic in many situations<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_73_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_l47i0_label\" class=\"frm_primary_label\">4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_l47i0_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_73-0\">\t\t\t<label  for=\"field_l47i0-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[73]\" id=\"field_l47i0-0\" value=\"0\"\n\t\t data-reqmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares cannot be blank.\" data-invmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_73-1\">\t\t\t<label  for=\"field_l47i0-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[73]\" id=\"field_l47i0-1\" value=\"1\"\n\t\t data-reqmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares cannot be blank.\" data-invmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares is invalid\"   \/> Occasional trouble falling asleep<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_73-2\">\t\t\t<label  for=\"field_l47i0-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[73]\" id=\"field_l47i0-2\" value=\"2\"\n\t\t data-reqmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares cannot be blank.\" data-invmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares is invalid\"   \/> Frequent awakenings or restless sleep<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_73-3\">\t\t\t<label  for=\"field_l47i0-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[73]\" id=\"field_l47i0-3\" value=\"3\"\n\t\t data-reqmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares cannot be blank.\" data-invmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares is invalid\"   \/> Persistent sleep disturbance causing fatigue<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_73-4\">\t\t\t<label  for=\"field_l47i0-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[73]\" id=\"field_l47i0-4\" value=\"4\"\n\t\t data-reqmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares cannot be blank.\" data-invmsg=\"4. Insomnia \u2014 difficulty falling asleep, restless or unsatisfying sleep, frequent awakenings, nightmares is invalid\"   \/> Near-total sleeplessness or severe sleep disruption<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_74_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_os121_label\" class=\"frm_primary_label\">5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_os121_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_74-0\">\t\t\t<label  for=\"field_os121-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[74]\" id=\"field_os121-0\" value=\"0\"\n\t\t data-reqmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion cannot be blank.\" data-invmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_74-1\">\t\t\t<label  for=\"field_os121-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[74]\" id=\"field_os121-1\" value=\"1\"\n\t\t data-reqmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion cannot be blank.\" data-invmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion is invalid\"   \/> Slight forgetfulness or reduced focus<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_74-2\">\t\t\t<label  for=\"field_os121-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[74]\" id=\"field_os121-2\" value=\"2\"\n\t\t data-reqmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion cannot be blank.\" data-invmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion is invalid\"   \/> Noticeable lapses in concentration or recall<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_74-3\">\t\t\t<label  for=\"field_os121-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[74]\" id=\"field_os121-3\" value=\"3\"\n\t\t data-reqmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion cannot be blank.\" data-invmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion is invalid\"   \/> Frequent confusion or inability to sustain attention<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_74-4\">\t\t\t<label  for=\"field_os121-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[74]\" id=\"field_os121-4\" value=\"4\"\n\t\t data-reqmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion cannot be blank.\" data-invmsg=\"5. Cognitive difficulties \u2014 poor concentration, memory problems, or mental confusion is invalid\"   \/> Constant disorientation or inability to think clearly<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_75_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_rqvi_label\" class=\"frm_primary_label\">6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_rqvi_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_75-0\">\t\t\t<label  for=\"field_rqvi-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[75]\" id=\"field_rqvi-0\" value=\"0\"\n\t\t data-reqmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings cannot be blank.\" data-invmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_75-1\">\t\t\t<label  for=\"field_rqvi-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[75]\" id=\"field_rqvi-1\" value=\"1\"\n\t\t data-reqmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings cannot be blank.\" data-invmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings is invalid\"   \/> Occasional sadness or loss of interest<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_75-2\">\t\t\t<label  for=\"field_rqvi-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[75]\" id=\"field_rqvi-2\" value=\"2\"\n\t\t data-reqmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings cannot be blank.\" data-invmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings is invalid\"   \/> Persistent low mood and emotional fluctuation<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_75-3\">\t\t\t<label  for=\"field_rqvi-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[75]\" id=\"field_rqvi-3\" value=\"3\"\n\t\t data-reqmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings cannot be blank.\" data-invmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings is invalid\"   \/> Deep sadness, marked loss of pleasure or motivation<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_75-4\">\t\t\t<label  for=\"field_rqvi-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[75]\" id=\"field_rqvi-4\" value=\"4\"\n\t\t data-reqmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings cannot be blank.\" data-invmsg=\"6. Depressed mood \u2014 loss of interest, sadness, apathy, mood swings is invalid\"   \/> Continuous depression, emotional paralysis or despair<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_76_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_bqd0w_label\" class=\"frm_primary_label\">7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils)\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_bqd0w_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_76-0\">\t\t\t<label  for=\"field_bqd0w-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[76]\" id=\"field_bqd0w-0\" value=\"0\"\n\t\t data-reqmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) cannot be blank.\" data-invmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_76-1\">\t\t\t<label  for=\"field_bqd0w-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[76]\" id=\"field_bqd0w-1\" value=\"1\"\n\t\t data-reqmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) cannot be blank.\" data-invmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) is invalid\"   \/> Slight tension or minor nervous movements<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_76-2\">\t\t\t<label  for=\"field_bqd0w-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[76]\" id=\"field_bqd0w-2\" value=\"2\"\n\t\t data-reqmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) cannot be blank.\" data-invmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) is invalid\"   \/> Noticeable restlessness or muscle tension<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_76-3\">\t\t\t<label  for=\"field_bqd0w-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[76]\" id=\"field_bqd0w-3\" value=\"3\"\n\t\t data-reqmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) cannot be blank.\" data-invmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) is invalid\"   \/> Marked physical agitation throughout the interview<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_76-4\">\t\t\t<label  for=\"field_bqd0w-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[76]\" id=\"field_bqd0w-4\" value=\"4\"\n\t\t data-reqmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) cannot be blank.\" data-invmsg=\"7. Behavior during the interview \u2014 physical signs of anxiety (trembling, fidgeting, tense expression, sighing, swallowing, widened pupils) is invalid\"   \/> Extreme, uncontrollable physical manifestations of anxiety<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_77_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_nbmm0_label\" class=\"frm_primary_label\">8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_nbmm0_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_77-0\">\t\t\t<label  for=\"field_nbmm0-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[77]\" id=\"field_nbmm0-0\" value=\"0\"\n\t\t data-reqmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness cannot be blank.\" data-invmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_77-1\">\t\t\t<label  for=\"field_nbmm0-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[77]\" id=\"field_nbmm0-1\" value=\"1\"\n\t\t data-reqmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness cannot be blank.\" data-invmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness is invalid\"   \/> Occasional sensory disturbances<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_77-2\">\t\t\t<label  for=\"field_nbmm0-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[77]\" id=\"field_nbmm0-2\" value=\"2\"\n\t\t data-reqmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness cannot be blank.\" data-invmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness is invalid\"   \/> Recurrent discomfort or mild sensory episodes<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_77-3\">\t\t\t<label  for=\"field_nbmm0-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[77]\" id=\"field_nbmm0-3\" value=\"3\"\n\t\t data-reqmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness cannot be blank.\" data-invmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness is invalid\"   \/> Frequent or distressing sensory symptoms<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_77-4\">\t\t\t<label  for=\"field_nbmm0-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[77]\" id=\"field_nbmm0-4\" value=\"4\"\n\t\t data-reqmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness cannot be blank.\" data-invmsg=\"8. Somatic (sensory) symptoms \u2014 blurred vision, tinnitus, hot or cold flashes, sensations of weakness is invalid\"   \/> Constant sensory disturbance, disabling intensity<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_78_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_1h1yg_label\" class=\"frm_primary_label\">9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_1h1yg_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_78-0\">\t\t\t<label  for=\"field_1h1yg-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[78]\" id=\"field_1h1yg-0\" value=\"0\"\n\t\t data-reqmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor cannot be blank.\" data-invmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_78-1\">\t\t\t<label  for=\"field_1h1yg-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[78]\" id=\"field_1h1yg-1\" value=\"1\"\n\t\t data-reqmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor cannot be blank.\" data-invmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor is invalid\"   \/> Slight muscle tension or stiffness<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_78-2\">\t\t\t<label  for=\"field_1h1yg-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[78]\" id=\"field_1h1yg-2\" value=\"2\"\n\t\t data-reqmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor cannot be blank.\" data-invmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor is invalid\"   \/> Frequent aches or noticeable tension<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_78-3\">\t\t\t<label  for=\"field_1h1yg-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[78]\" id=\"field_1h1yg-3\" value=\"3\"\n\t\t data-reqmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor cannot be blank.\" data-invmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor is invalid\"   \/> Continuous muscular discomfort or spasms<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_78-4\">\t\t\t<label  for=\"field_1h1yg-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[78]\" id=\"field_1h1yg-4\" value=\"4\"\n\t\t data-reqmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor cannot be blank.\" data-invmsg=\"9. Somatic (muscular) symptoms \u2014 muscle aches, stiffness, tension, twitching, teeth grinding, voice tremor is invalid\"   \/> Persistent severe pain or involuntary contractions<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_79_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_k3b3u_label\" class=\"frm_primary_label\">10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_k3b3u_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_79-0\">\t\t\t<label  for=\"field_k3b3u-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[79]\" id=\"field_k3b3u-0\" value=\"0\"\n\t\t data-reqmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness cannot be blank.\" data-invmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_79-1\">\t\t\t<label  for=\"field_k3b3u-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[79]\" id=\"field_k3b3u-1\" value=\"1\"\n\t\t data-reqmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness cannot be blank.\" data-invmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness is invalid\"   \/> Occasional palpitations or brief heart awareness<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_79-2\">\t\t\t<label  for=\"field_k3b3u-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[79]\" id=\"field_k3b3u-2\" value=\"2\"\n\t\t data-reqmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness cannot be blank.\" data-invmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness is invalid\"   \/> Recurrent palpitations or mild chest tightness<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_79-3\">\t\t\t<label  for=\"field_k3b3u-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[79]\" id=\"field_k3b3u-3\" value=\"3\"\n\t\t data-reqmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness cannot be blank.\" data-invmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness is invalid\"   \/> Persistent chest discomfort or racing heartbeat<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_79-4\">\t\t\t<label  for=\"field_k3b3u-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[79]\" id=\"field_k3b3u-4\" value=\"4\"\n\t\t data-reqmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness cannot be blank.\" data-invmsg=\"10. Cardiovascular symptoms \u2014 chest pain, palpitations, irregular heartbeat, pulsation, faintness is invalid\"   \/> Disabling cardiovascular distress or fainting sensations<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_80_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_v67q9_label\" class=\"frm_primary_label\">11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_v67q9_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_80-0\">\t\t\t<label  for=\"field_v67q9-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[80]\" id=\"field_v67q9-0\" value=\"0\"\n\t\t data-reqmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness cannot be blank.\" data-invmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_80-1\">\t\t\t<label  for=\"field_v67q9-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[80]\" id=\"field_v67q9-1\" value=\"1\"\n\t\t data-reqmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness cannot be blank.\" data-invmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness is invalid\"   \/> Occasional shortness of breath or sighing<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_80-2\">\t\t\t<label  for=\"field_v67q9-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[80]\" id=\"field_v67q9-2\" value=\"2\"\n\t\t data-reqmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness cannot be blank.\" data-invmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness is invalid\"   \/> Frequent episodes of respiratory discomfort<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_80-3\">\t\t\t<label  for=\"field_v67q9-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[80]\" id=\"field_v67q9-3\" value=\"3\"\n\t\t data-reqmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness cannot be blank.\" data-invmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness is invalid\"   \/> Persistent tightness or difficulty breathing<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_80-4\">\t\t\t<label  for=\"field_v67q9-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[80]\" id=\"field_v67q9-4\" value=\"4\"\n\t\t data-reqmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness cannot be blank.\" data-invmsg=\"11. Respiratory symptoms \u2014 shortness of breath, sighing, feelings of choking or tightness is invalid\"   \/> Near-constant choking or suffocating sensation<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_81_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_fjf3s_label\" class=\"frm_primary_label\">12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_fjf3s_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_81-0\">\t\t\t<label  for=\"field_fjf3s-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[81]\" id=\"field_fjf3s-0\" value=\"0\"\n\t\t data-reqmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation cannot be blank.\" data-invmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_81-1\">\t\t\t<label  for=\"field_fjf3s-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[81]\" id=\"field_fjf3s-1\" value=\"1\"\n\t\t data-reqmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation cannot be blank.\" data-invmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation is invalid\"   \/> Occasional stomach upset or mild nausea<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_81-2\">\t\t\t<label  for=\"field_fjf3s-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[81]\" id=\"field_fjf3s-2\" value=\"2\"\n\t\t data-reqmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation cannot be blank.\" data-invmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation is invalid\"   \/> Frequent digestive discomfort or irregularity<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_81-3\">\t\t\t<label  for=\"field_fjf3s-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[81]\" id=\"field_fjf3s-3\" value=\"3\"\n\t\t data-reqmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation cannot be blank.\" data-invmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation is invalid\"   \/> Persistent pain, nausea, or bowel disturbance<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_81-4\">\t\t\t<label  for=\"field_fjf3s-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[81]\" id=\"field_fjf3s-4\" value=\"4\"\n\t\t data-reqmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation cannot be blank.\" data-invmsg=\"12. Gastro-intestinal symptoms \u2014 burning sensation, nausea, vomiting, abdominal pain, bloating, diarrhea, constipation is invalid\"   \/> Constant gastrointestinal distress interfering with eating<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_82_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_zca9q_label\" class=\"frm_primary_label\">13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_zca9q_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_82-0\">\t\t\t<label  for=\"field_zca9q-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[82]\" id=\"field_zca9q-0\" value=\"0\"\n\t\t data-reqmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido cannot be blank.\" data-invmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_82-1\">\t\t\t<label  for=\"field_zca9q-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[82]\" id=\"field_zca9q-1\" value=\"1\"\n\t\t data-reqmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido cannot be blank.\" data-invmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido is invalid\"   \/> Slight changes in urination or libido<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_82-2\">\t\t\t<label  for=\"field_zca9q-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[82]\" id=\"field_zca9q-2\" value=\"2\"\n\t\t data-reqmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido cannot be blank.\" data-invmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido is invalid\"   \/> Noticeable frequency or mild sexual difficulties<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_82-3\">\t\t\t<label  for=\"field_zca9q-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[82]\" id=\"field_zca9q-3\" value=\"3\"\n\t\t data-reqmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido cannot be blank.\" data-invmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido is invalid\"   \/> Persistent sexual dysfunction or urinary urgency<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_82-4\">\t\t\t<label  for=\"field_zca9q-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[82]\" id=\"field_zca9q-4\" value=\"4\"\n\t\t data-reqmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido cannot be blank.\" data-invmsg=\"13. Genito-urinary symptoms \u2014 frequent urination, sexual dysfunction, loss of libido is invalid\"   \/> Disabling genito-urinary problems, marked loss of function<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_83_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n\t<div  id=\"field_qog9n_label\" class=\"frm_primary_label\">14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n\t<\/div>\r\n\t<div class=\"frm_opt_container\" aria-labelledby=\"field_qog9n_label\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_83-0\">\t\t\t<label  for=\"field_qog9n-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[83]\" id=\"field_qog9n-0\" value=\"0\"\n\t\t data-reqmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end cannot be blank.\" data-invmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end is invalid\"   \/> None<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_83-1\">\t\t\t<label  for=\"field_qog9n-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[83]\" id=\"field_qog9n-1\" value=\"1\"\n\t\t data-reqmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end cannot be blank.\" data-invmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end is invalid\"   \/> Occasional mild autonomic responses<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_83-2\">\t\t\t<label  for=\"field_qog9n-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[83]\" id=\"field_qog9n-2\" value=\"2\"\n\t\t data-reqmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end cannot be blank.\" data-invmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end is invalid\"   \/> Frequent sweating, flushing, or light-headedness<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_83-3\">\t\t\t<label  for=\"field_qog9n-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[83]\" id=\"field_qog9n-3\" value=\"3\"\n\t\t data-reqmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end cannot be blank.\" data-invmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end is invalid\"   \/> Persistent autonomic disturbances<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_83-4\">\t\t\t<label  for=\"field_qog9n-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[83]\" id=\"field_qog9n-4\" value=\"4\"\n\t\t data-reqmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end cannot be blank.\" data-invmsg=\"14. Autonomic (nervous-system) symptoms \u2014 dry mouth, flushing, pallor, sweating, dizziness, headache, hair standing on end is invalid\"   \/> Constant, disabling autonomic instability<\/label><\/div>\n<\/div>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_84_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n\t<label for=\"field_3xto4\" id=\"field_3xto4_label\" class=\"frm_primary_label\">Total Score\r\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n\t<\/label>\r\n\t<input type=\"number\" id=\"field_3xto4\" name=\"item_meta[84]\" value=\"\" readonly=\"readonly\"  data-invmsg=\"Total Score is invalid\" aria-invalid=\"false\"   min=\"0\" max=\"9999999999999999999999999999\" step=\"1\" \/>\r\n\t\r\n\t\r\n<\/div>\n<div id=\"frm_field_66_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit frm_flex\">\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"   formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_735_container\">\n\t\t\t<label for=\"field_du4h7\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_du4h7\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[735]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"G1zW67fsZ32xVh1r9ioDku9I\/LZ95WtoiA8hOBac48aZ8jIHn+76wY59VENT14p\/\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-6125","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>HAM-A - My Soul Space<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/mysoulspace.net\/en\/ham-a\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"HAM-A - My Soul Space\" \/>\n<meta property=\"og:url\" content=\"https:\/\/mysoulspace.net\/en\/ham-a\/\" \/>\n<meta property=\"og:site_name\" content=\"My Soul Space\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/mysoulspace.net\\\/en\\\/ham-a\\\/\",\"url\":\"https:\\\/\\\/mysoulspace.net\\\/en\\\/ham-a\\\/\",\"name\":\"HAM-A - My Soul Space\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/mysoulspace.net\\\/#website\"},\"datePublished\":\"2025-10-31T12:57:39+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/mysoulspace.net\\\/en\\\/ham-a\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/mysoulspace.net\\\/en\\\/ham-a\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/mysoulspace.net\\\/en\\\/ham-a\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"\u0627\u0644\u0631\u0626\u064a\u0633\u064a\u0629\",\"item\":\"https:\\\/\\\/mysoulspace.net\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"HAM-A\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/mysoulspace.net\\\/#website\",\"url\":\"https:\\\/\\\/mysoulspace.net\\\/\",\"name\":\"My Soul Space\",\"description\":\"We transform psychology from mere theories into practical, everyday experiences through self-education, online or in-person therapy sessions, in addition to practical digital tools that help individuals and families achieve psychological balance and self-development.\",\"publisher\":{\"@id\":\"https:\\\/\\\/mysoulspace.net\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/mysoulspace.net\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/mysoulspace.net\\\/#organization\",\"name\":\"My Soul Space\",\"url\":\"https:\\\/\\\/mysoulspace.net\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/mysoulspace.net\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/mysoulspace.net\\\/wp-content\\\/uploads\\\/2025\\\/11\\\/soul-LOGO-PNG-FITTED.jpg\",\"contentUrl\":\"https:\\\/\\\/mysoulspace.net\\\/wp-content\\\/uploads\\\/2025\\\/11\\\/soul-LOGO-PNG-FITTED.jpg\",\"width\":1350,\"height\":913,\"caption\":\"My Soul Space\"},\"image\":{\"@id\":\"https:\\\/\\\/mysoulspace.net\\\/#\\\/schema\\\/logo\\\/image\\\/\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"HAM-A - My Soul Space","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/mysoulspace.net\/en\/ham-a\/","og_locale":"en_US","og_type":"article","og_title":"HAM-A - My Soul Space","og_url":"https:\/\/mysoulspace.net\/en\/ham-a\/","og_site_name":"My Soul Space","twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/mysoulspace.net\/en\/ham-a\/","url":"https:\/\/mysoulspace.net\/en\/ham-a\/","name":"HAM-A - My Soul Space","isPartOf":{"@id":"https:\/\/mysoulspace.net\/#website"},"datePublished":"2025-10-31T12:57:39+00:00","breadcrumb":{"@id":"https:\/\/mysoulspace.net\/en\/ham-a\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/mysoulspace.net\/en\/ham-a\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/mysoulspace.net\/en\/ham-a\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"\u0627\u0644\u0631\u0626\u064a\u0633\u064a\u0629","item":"https:\/\/mysoulspace.net\/"},{"@type":"ListItem","position":2,"name":"HAM-A"}]},{"@type":"WebSite","@id":"https:\/\/mysoulspace.net\/#website","url":"https:\/\/mysoulspace.net\/","name":"My Soul Space","description":"We transform psychology from mere theories into practical, everyday experiences through self-education, online or in-person therapy sessions, in addition to practical digital tools that help individuals and families achieve psychological balance and self-development.","publisher":{"@id":"https:\/\/mysoulspace.net\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/mysoulspace.net\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/mysoulspace.net\/#organization","name":"My Soul Space","url":"https:\/\/mysoulspace.net\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/mysoulspace.net\/#\/schema\/logo\/image\/","url":"https:\/\/mysoulspace.net\/wp-content\/uploads\/2025\/11\/soul-LOGO-PNG-FITTED.jpg","contentUrl":"https:\/\/mysoulspace.net\/wp-content\/uploads\/2025\/11\/soul-LOGO-PNG-FITTED.jpg","width":1350,"height":913,"caption":"My Soul Space"},"image":{"@id":"https:\/\/mysoulspace.net\/#\/schema\/logo\/image\/"}}]}},"_links":{"self":[{"href":"https:\/\/mysoulspace.net\/en\/wp-json\/wp\/v2\/pages\/6125","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mysoulspace.net\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/mysoulspace.net\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/mysoulspace.net\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mysoulspace.net\/en\/wp-json\/wp\/v2\/comments?post=6125"}],"version-history":[{"count":1,"href":"https:\/\/mysoulspace.net\/en\/wp-json\/wp\/v2\/pages\/6125\/revisions"}],"predecessor-version":[{"id":6126,"href":"https:\/\/mysoulspace.net\/en\/wp-json\/wp\/v2\/pages\/6125\/revisions\/6126"}],"wp:attachment":[{"href":"https:\/\/mysoulspace.net\/en\/wp-json\/wp\/v2\/media?parent=6125"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}