The purpose of this test is to identify and measure the severity of symptoms associated with anxiety. It is useful for measuring a patient's progress.

Scoring: Assign a value of 0 to 4 to each question. At the end. score the total test. Scores above 30 are usually considered abnormal, and scores above 80 are noted as severe. The mean score in panic disorder and agoraphobia is 57 + or - 20. The goal of treatment is to bring the score below 20.

Symptom detected....................................

0
Not At All

1
A Little

2
Moderately

3
Quite a Bit

4
Extremely

1. Difficulty in getting your breath, smothering, or over breathing.

2. Choking sensation or a lump in the throat

3. Skipping, racing, or pounding of your heart

4. Chest Pain, pressure, or discomfort

5. Bouts of excessive sweating

6. Faintness, light-headedness, or dizzy spells

7. Sensation of rubbery or "jelly" legs

8. Feeling off balance or unsteady like you might fall

9. Nausea or stomach problems

10. Feeling that things around you are strange, unreal, foggy, or detached from you

11. Feeling outside or detached from part or all of your body, or a floating freely

12. Tingling or numbness in parts of your body

13. Hot flashes or cold chills

14. Shaking or trembling

15. Having a fear that you are dying or that something terrible is about to happen

16. Feeling you are loosing control or going insane

17. Sudden anxiety attacks with three or more of the symptoms listed above that occur when you are in or are about to go into a situation that is likely, from your experience, to bring on an attack

18. Sudden unexpected anxiety attacks with three or more symptoms listed above that occur with little or no provocation (i.e. when you are NOT in a situation that is likely, from your experience to bring on an attack)

19. Sudden unexpected spells with only one or two symptoms (listed above) that occur with little or no provocation (i.e. when you are NOT in a situation that is likely , from your experience, to bring on an attack)

20. Anxiety episodes that build up as you anticipate doing something that is likely, from your experience, to bring on anxiety that is more intense than most people experience in such situations

21. Avoiding situations because they frighten you

22. Being dependent on others

23. Tension and inability to relax

24. Anxiety, nervousness, restlessness

25. Spells of increased sensitivity to sound, light, or touch

26. Attacks of diarrhea

27. Worrying about your health too much

28. Feeling tired, weak, and exhausted easily

29. Headaches or pains in the neck or head

30. Difficulty in falling asleep

31. Waking in the middle of the night, or restless sleep

32. Unexpected waves of depression occurring with little or no provocation

33. Emotions and moods going up and down a lot in response to changes around you.

34. Recurrent and persistent ideas, thoughts, impulses, or images that are intrusive, unwanted, senseless, or repugnant 35. Having to repeat the same action in a ritual, e.g., checking, washing, counting repeatedly, when it's not really necessary