Bellow is a list of phrases that describe certain feeling that people have. Please select one of the five responses for each of the 14 questions.
0 = Not Present 1 = Mild 2 = Moderate 3 = Severe 4 = Very Severe
Worries, anticipation, of the words, fearful anticipation, irritability.
Feeling of tension, fatiguability, startle response, moved to tears easily, trembling, feelings of restlessness, inability to relax.
Of dark, of strangers, of being alone, of animals, of trafic, of crowds.
Difficulty in falling to asleep, broken sleep, unsatisfying sleep, and fatigue on walking, dreams, nightmares, night terrors.
Difficulty in concentration, poor memory
Loss of interest, lack of pleasure in hobbies, depression, early walking, diurnal swing.
Pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.
Tinnitus, blurring of vision, hot and cold flashes, feeling of weakness, pricking sensation.
Tachycardia, palpitations pain in chest, throbbing of vessels, fainting feelings, missing beats.
Pressure or constriction in chest, choking feeling, sighing, dyspnea.
Difficulty in swallowing, wind abdominal pain, burning sensations, abdominal fullness, nausea, vomiting, borborygmi, looseness of bowels, loss of weight, constipation.
Frequency of micturition, urgency of micturition, amenorrhea, menorrhagia, development of frigidity, premature ejaculation, loss of libido, impotence.
Dry mouth, flushing, pallor, tendency to sweat, giddiness, tension, headache, raising of hair.
Fidgeting, restlessness or pacing, tremor of hands, furrowed brow, strained face, sighing or rapid respiration, facial pallor, swallowing, etc.