| No. | Behavior | Never | Less often | No change | More often | Always | Explanation & example |
| 1 | Sleep | ||||||
| 2 | Vomit | ||||||
| 3 | Feel alert &focused | ||||||
| 4 | Feel greedy | ||||||
| 5 | Feel generous | ||||||
| 6 | Eat | ||||||
| 7 | Bowel urgency | ||||||
| 8 | Move around | ||||||
| 9 | Feel stiff (not able to move) | ||||||
| 10 | Feel afraid | ||||||
| 11 | Feel happy | ||||||
| 12 | Deal with problems, situations, people | ||||||
| 13 | Avoid People | ||||||
| 14 | Perform sexual activity | ||||||
| 15 | Perform mental/intellectual activity | ||||||
| 16 | Drink | ||||||
| 17 | Urgetourinate | ||||||
| 18 | Quarrel | ||||||
| 19 | Feel peaceable | ||||||
| 20 | Feel like fighting | ||||||
| 21 | Feel resigned and non-resistant | ||||||
| 22 | Feel jealous | ||||||
| 23 | Feel indulgend | ||||||
| 24 | Work | ||||||
| 25 | Rest | ||||||
| 26 | Talk | ||||||
| 27 | Listen | ||||||
| 28 | Feel pleased | ||||||
| 29 | Feel annoyed/irritaded | ||||||
| 30 | Laugh | ||||||
| 31 | Cry | ||||||
| 32 | Communicate with others | ||||||
| 33 | Seclude yourself | ||||||
| 34 | Feel cheerful | ||||||
| 35 | Feelsad |