T

F

1.  I do most of my drinking alone.

T

F

2.  I need an early morning drink.

T

F

3.  Drinking is causing me problems in my family relationships.

T

F

4.  I am frequently absent from work because of drinking.

T

F

5.    Drinking alleviates my feelings of inadequacy.

T

F

6.     If I stop drinking I get the shakes.

T

F

7.     I pay less attention to my spouse/loved one because of drinking.

T

F

8.     My reputation is suffering because of drinking.

T

F

9.     I have experienced blackouts (loss of memory) after drinking.

T

F

10. My business is suffering because of my drinking.

T

F

11.  I lose sexual potency after drinking.

T

F

12.  I have bodily complaints after drinking.

T

F

13. I have trouble limiting the amount I drink.

T

F

14.  I drink at lunch.

T

F

15.  My moods change markedly when I drink.

T

F

16.  When I drink I have trouble sleeping.

T

F

17.  I am more impulsive after I drink.

T

F

18.  I have less self-control when I drink.

T

F

19. I drink in social situations to relieve anxiety.

T

F

20.  I am harder to get along with when I drink.