Test for Alcohol Dependence – Rice Purity Test

This questionnaire was developed specifically to help to understand the progression of symptoms of addiction from early to late stage. The aim was not to scare but to inform. Included here are typical symptoms related to each stage of the addiction, allow a detailed look at the nature and progression of the disease from a position of experience. The author of the Rice Purity Test: Canadian psychiatrist E. M. Jellinek.

How you answer truthfully. If your answer is “sometimes”, write “Yes.” Some questions actually contain a few questions and if you answer “Yes” to even one of these questions, consider your answer to the question as a Yes.

1. Are Your close relatives — grandfather, grandmother, parents, brothers, sisters, alcoholics or drug addicts?

Yes No

2. Do you drink usually more than your friends? Do you often one of the last to leave the bar?

Yes No

3. Whether you enjoy drinking and impatient waiting for the perfect opportunity? Consider whether you have a big fan of parties?

Yes No

4. Do you find that you do not want to stop drinking after one or two drinks, while others have enough?

Yes No

5. Has there been any changes in the nature of your alcohol consumption — drinking more and more often, drank one and switched to more spirits?

Yes No

6. Showed any restlessness or dissatisfaction with your booze close to you people — wife, husband, parents, children?

Yes No

7. Lead You into a state of anxiety and irritation thoughts about non-alcoholic events — Church wedding, reception with soft drinks, etc.?

Yes No

8. Surprised if you ever wonder why some of your friends so drink slowly or stop drinking after an hour or two? Have you bought alcohol for friends, trying to “support” a party?

Yes No

9. Do you drink in one gulp the first drink and then when you feel the effect slow down the pace to the level of others?

Yes No

10. Sorry if You sometimes sober, about what you said or did while drunk? Whether you recognize yourself to blame for your behavior in front of you loving people and promised to change?

Yes No

11. Did you ever stop drinking for a certain period of time (weeks or maybe months) because he felt that “it would be good for you” or because I wanted to prove that you can?

Yes No

12. If you promised yourself that you’ll control the amount of alcohol consumed will reduce this number and has not fulfilled that promise?

Yes No

13. Can you now drink more than a year ago? Is there a tendency to drink much more?

Yes No

14. Have you ever had a memory loss (You may not remember some or all events that happened when you were drunk?) Do you have it now more than a year ago?

Yes No

15. Did you have difficulties at work, persistent disease, it’s difficult to concentrate claims on the part of colleagues or superiors — those that could be associated with your booze?

Yes No

16. Did you feel sometimes better when you drink than when you are drinking? Whether the booze was delivered you from headache, tension, anxiety, mood swings?

 Yes

 No

17. Did you feel growing guilt about his drinking, but, nevertheless, when someone loves you showed your concern, you became hostile and tried to defend himself?

Yes No

18. Do you tend to think your problems are the result of tension and stress or that you do not understand your spouse(s), or impose excessive demands at work? Did you feel sorry for yourself because you felt that nobody understands? Did you to alcohol for solace and reassurance?

Yes No

19. Do you have a craving for alcohol is strong desire to drink that you are willing to risk a quarrel with your spouse (oops) or get a reprimand from the boss?

Yes No

20. Increases if you have a tendency to drink more than you expected in the beginning? Do you find it hard to stop drinking once started? If you were drinking sometime immediately after waking up?

Yes No

21. Do you sometimes, after drinking, trembling hands with which you cannot cope? Do you feel physically sick (nausea, shaking, weakness) and/or there are psychotic disorders (depression, anxiety, agitation, bad mood, irritation), if you’re not drinking? Does alcohol improve your health?

Yes No

22. Do you have the disease or disorder in the body, which may be associated with alcohol, such as gastritis, recurrent diarrhea, immunodeficiency virus, nosebleeds, hypertension, pneumonia, rapid heartbeat, enlarged liver, abscesses, hepatitis, cirrhosis, delirium tremens, epilepsy or pancreatitis?

Yes No

23. Were You hospitalized due to injuries, accidents or injuries that occurred during the drinking bout and, perhaps, due to the fact that drank too much?

Yes No

24. Do you have ever thought about suicide? Did you have hallucinations after a binge or when taking cocaine? Did you have irrational fears (for example, whether you in a state of anxiety and fear the doorbell or telephone call)?

Yes No

25. Have you had any losses due to drinking job loss, divorce, alienation of children or family, arrest for driving while intoxicated, loss of property, business contacts, etc.?

Yes No

26. Do you neglect food, especially during and immediately after the binge? Not if you stopped to deal with them, stopped doing the exercise, take a shower, to go to the doctor if there are health problems?

Yes No

27. Whether you are drinking less than you could once, and when you drink, do you have a tendency to get drunk before consciousness loss, or to such satiety that you simply can’t?

Yes No

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