**** *** CIS20R **** ***
	Checklist Individual Strength
	University Hospital Nijmegen
	Department of Medical Psychology
Instruction:
On the next page you find 20 statements. With these statements we wish to get an impression of how you have felt during the past two weeks. For example:
	I feel relaxed
If you feel that this statement is not true at all, place a cross in the right box; like this:
I feel relaxed	yes, that is true	X							no, that is not true
If you feel that this statement is not true at all, place a cross in the right box; like this:
I feel relaxed	yes, that is true							X	no, that is not true
If you feel that this statement in not “yes, that is true”, but also not “no, that is not true”, place a cross in the box that is most in accordance with how you have felt.
For example, if you feel relaxed, but not very relaxed, place a cross in one of the boxes close to “yes, that is true": like this:
I feel relaxed	yes, that is true			X					no, that is not true
Do not skip any statement and place only one cross for each statement.
1. I feel tired	yes, that is true								no, that is not true
2. I feel very active	yes, that is true								no, that is not true
3. Thinking requires effort	yes, that is true								no, that is not true
4. Physically I feel exhausted	yes, that is true								no, that is not true
5. I feel like doing all kinds of nice things	yes, that is true								no, that is not true
6. I feel fit	yes, that is true								no, that is not true
7. I do quite a lot within a day	yes, that is true								no, that is not true
8. When I am doing something, I can concentrate quite well	yes, that is true								no, that is not true
9. I feel weak	yes, that is true								no, that is not true
10. I don't do much during the day	yes, that is true								no, that is not true
11. I can concentrate well	yes, that is true								no, that is not true
12. I feel rested	yes, that is true								no, that is not true
13. I have trouble concentrating	yes, that is true								no, that is not true
14. Physically I feel I am in a bad condition	yes, that is true								no, that is not true
15. I am full of plans	yes, that is true								no, that is not true
16. I get tired very quickly	yes, that is true								no, that is not true
17. I have a low output	yes, that is true								no, that is not true
18. I feel no desire to do anything	yes, that is true								no, that is not true
19. My thoughts easily wander	yes, that is true								no, that is not true
20. Physically I feel in a good shape	yes, that is true								no, that is not true
SCORING CIS20R
For the items:2, 5, 6, 7, 8, 11, 12, 15, 20 is the scoring as follows:
	yes, that is true	1	2	3	4	5	6	7	no, that is not true
For the items: 1, 3, 4, 9, 10, 13, 14, 16, 17, 18, 19is the scoring as follows:
	yes, that is true	7	6	5	4	3	2	1	no, that is not true
Subsequently the four subscales are calculated by summing the respective items
subscale 1: Subjective feeling of fatigue	items 1, 4, 6, 9, 12, 14, 16, 20
subscale 2: Concentration	items 3, 8, 11, 13, 19
subscale 3: Motivation	items 2, 5, 15, 18
subscale 4: Physical activity	items 7, 10, 17