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. 2007 Jan-Mar;1(1):81–88. doi: 10.1590/S1980-57642008DN10100013
A. Self-Consciousness Questionnaire 8. Do you feel rather happy or unhappy? Why?
1. What is your name (surname and first name)? 9. Would you say that you are rather fair or dark-haired?
2. Why have you come to see me? 10. Are you now sitting, standing or lying down?
3. Do you have any health problems that prevent you from 11. What are you planning to do shortly or tomorrow?
leading a normal life? 12. If you had to live your life over again, is there anything you
4. Have you got any problem with your memory? would like to change? What?
5. Have you had a job? What was it? 13. Is it a good thing or a bad thing to tell a lie? Why?
6. What is the first name of your spouse (or partner)? 14. Is it a good thing or a bad thing to give some money or
7. What is your mother´s first name? some food to someone who is starving? Why?
 
B. Denial of Illness Scale
Questions Scoring    
1. Patient minimizes present symptoms (at interview). 0 (no) 1 (once or twice) 2 (more than twice)
2. Patient alludes to there being nothing really wrong with her or 0 (no) 1 (once or twice) 2 (more than twice)
him and that she or he is ready to go home.      
3. Patient (past or present) displaces source of symptoms to organs (no) 1 (once or twice) 2 (more than twice)
other than brain or complains of symptoms unrelated to the      
central nervous system.      
4. Did the patient at any time admit to fear of death? 0 (yes) 1 (no)  
5. Did the patient at any time admit to fear of invalidism? 0 (yes) 1 (no)  
6. Patient verbally denies being in the hospital. 0 (not at all) 1 (sometimes) 2 (every time)
7. Patient displays, at least on the surface, a carefree, cheerful, 0 (no) 1 (once or twice) 2 (more than twice)
jovial approach to life.      
8. Patient´s behavior during interview is characterized by 0 (no) 1 (once or twice) 2 (more than twice)
nonchalance, coolness, imperturbablity.      
9. Patient displaces fear for his or her own illness to family, older 0 (no) 1 (at least 1 time during  
patients, weaker patients, and so on.   the interview)  
10.Patient projects illness or weakness to family, spouse, and so on 0 (no) 1 (at least 1 time during the interview)