Questions:

1. I tend to worry about things, even when there are no signs of trouble.
    Never
    Seldom
    Sometimes
    Often
    Very often
   

2. My body often feels so tense, I'm unable to relax.
    Never
    Seldom
    Sometimes
    Often
    Very often
   

3. I avoid certain things or situations—for example, dogs, traveling in airplanes, closed-in places, heights, escalators, highway driving--because they make me feel afraid.
    Never
    Seldom
    Sometimes
    Often
    Very often
   

4. Out of the blue, my heart starts rapidly pounding.
    Never
    Seldom
    Sometimes
    Often
    Very often
   

5. My emotions and moods go up and down a lot in response to changes around me.
    Never
    Seldom
    Sometimes
    Often
    Very often
   

6. I suddenly feel frightened and shake or tremble even when there are no signs of trouble.
    Never
    Seldom
    Sometimes
    Often
    Very often
   

7. At times, things seem unreal or I feel detached from everything around me.
    Never
    Seldom
    Sometimes
    Often
    Very often
   

8. I get aches or pains that can’t be traced to physical illness or injury.
    Never
    Seldom
    Sometimes
    Often
    Very often
   

9. When other people look at me, I break out in a sweat and shake uncontrollably.
    Never
    Seldom
    Sometimes
    Often
    Very often
   

10. I stay home from work or school because I'm afraid of being called on in a meeting or in class.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

11. I have nightmares.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

12. I unexpectedly get hot flashes or cold chills for no apparent reason.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

13. I get nausea or have stomach problems that are not caused by illness or a medical condition.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

14. I worry that I might lose control or do something that will be very embarrassing.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

15. I feel afraid and have difficulty catching my breath.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

16. I have unexpected spells of increased sensitivity to sound, light, or touch.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

17. I have frequent and sudden attacks of diarrhea.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

18. I get tired easily.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

19. I have difficulty falling asleep.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

20. I sleep restlessly and/or wake up in the middle of the night and can't get back to sleep.
     Never
     Seldom
     Sometimes
     Often
     Very often
    

21. I have unexpected waves of depression that occur with little or no real provocation.
     Never
     Seldom
     Sometimes
     Often
     Very often