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Instruction manual for the cohen-mansfield agitation inventory

Instruction manual for the cohen-mansfield agitation inventory

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FREQUENCY DISRUPTIVENESS<br />

14. Biting 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

15. Scratching 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

16. Trying to get to<br />

a different place 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

(e.g., out of <strong>the</strong><br />

room, building)<br />

17. Intentional 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

falling<br />

18. Complaining 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

19. Negativism 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

20. Eating/drinking<br />

inappropriate 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

substances<br />

21. Hurt self or<br />

o<strong>the</strong>r (cigarette, 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

hot water, etc.)<br />

22. Handling things 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

inappropriately<br />

23. Hiding things 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

24. Hoarding things 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

25. Tearing things<br />

or destroying 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

property<br />

26. Per<strong>for</strong>ming<br />

repetitious 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

mannerisms<br />

27. Making verbal 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

sexual advances<br />

28. Making physical 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

sexual advances<br />

29. General 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

restlessness<br />

30. O<strong>the</strong>r inappropriate behavior 1 2 3 4 5 6 7 9 1 2 3 4 5 9<br />

specify:_______________________<br />

© Cohen-Mansfield, 1986. All rights reserved.<br />

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