Please read each statement carefully and circle the number that you think best describes your condition over the past week, including today.
Items | 0 | 1 | 2 | 3 |
---|---|---|---|---|
1. Occasionally, I feel numbness and tingling in my body as well as weakened senses. | ||||
2. I feel excited. | ||||
3. Sometimes I feel wobbly in my legs. | ||||
4. I am unable to relax. | ||||
5. I feel afraid that something really bad is going to happen. | ||||
6. I feel dizzy. | ||||
7. Sometimes my heart pounds and races. | ||||
8. Sometimes I feel unsteady. | ||||
9. I often feel terrified and scared. | ||||
10. I feel nervous. | ||||
11. Sometimes I feel like being choked. | ||||
12. My hands tremble often. | ||||
13. I am unsteady, shaky and unable to relax. | ||||
14. I feel so afraid to the point of losing control. | ||||
15. Sometimes I find it difficult to breathe. | ||||
16. I am afraid that I am going to die. | ||||
17. I feel extreme and unrealistic fear. | ||||
18. I often suffer from indigestion and my stomach feels uncomfortable. | ||||
19. Sometimes I feel like I am going to faint. | ||||
20. My face often gets flushed. | ||||
21. I sweat a lot. (not from being hot) |