1. I have heart palpitations or accelerated heart rate
always sometimes never
2. I feel dizzy, unsteady, lightheaded or faint
3. I have a strong or persistent fear that is triggered by specific objects or situations
4. I avoid situations that cause me great fear
5. My normal routine is interrupted because of my fear of specific objects or situations
6. I engage in repetitive behaviors (e.g., hand washing, checking, counting) that I must do
7. I engage in recurrent thoughts that cause me to feel anxious
8. I experienced a catastrophic event and have recurrent and distressing recollections
9. I experienced a catastrophic event and have difficulty concentrating, falling asleep, or persistent anger
10. I experienced a catastrophic event and I don't seem to want to be with others
11. I worry about events and activities such as school or work performance
12. I have difficulty concentrating, have muscle tension, feel restless, irritable or sleep disturbance
13. My social, occupational or marital areas of my life are causing me distress
14. I must be active at all times and feel that idle time is wasted time
15. I feel anxiety or dread
