Please answer each
item by placing the number in the blank which most
clearly describes how you feel.
1 = rarely or none of the time
2 = a little of the time
3 = some of the time
4 = a good part of the time
5 = most or all of the time
__ 1. I feel calm.
__ 2. I feel tense.
__ 3. I feel suddenly scared for no reason.
__ 4. I feel nervous.
__ 5. I use tranquilizers or antidepressants to cope with my anxiety.
__ 6. I feel confident about the future.
__ 7. I am free from senseless or unpleasant thoughts.
__ 8. I feel afraid to go out of my house alone.
__ 9. I feel relaxed and in control of myself.
__ 10. I have spells of terror or panic.
__ 11. I feel afraid in open spaces or in streets.
__ 12. I feel afraid I will faint in public.
__ 13. I am confortable traveling on buses, subways, or trains.
__ 14. I feel nervousness or shakiness inside.
__ 15. I feel comfortable in crowds, such as shopping or at a movie.
__ 16. I feel comfortable when I am left alone.
__ 17. I rarely feel afraid without good reason.
__ 18. Due to my fears, I unreasonably avoid certain animals, objects, or situations.
__ 19. I get upset easily or feel panicky unexpectedly.
__ 20. My hands, arms, or legs shake or tremble.
__ 21. Due to my fears, I avoid social situations whenever possible.
__ 22. I experience sudden attacks of panic which catch me by surprise.
__ 23. I feel generally anxious.
__ 24. I am bothered by dizzy spells.
__ 25. Due to my fears, I avoid being alone whenever possible.
This scale focuses on the amount, degree, and severity
of clinical anxiety. Higher scores represent greater
anxiety. After reverse-scoring items 1,6,7,9,13,15-17,
all items are totalled, resulting in a range of 0
to 100. |
