Services: Anxiety Inventory
ANXIETY INVENTORY
INSTRUCTIONS: The symptoms of anxiety can be divided into those affecting feelings, thoughts and the body. To find out the level of your anxiety, circle the number that best describes how much that symptom or problem has bothered you. You add up your score and interpret it according to the scale at the bottom.
Category I: Anxious Feelings Not at all Somewhat Moderately A Lot
1. Anxiety, nervousness, worry or fear 0 1 2 3
2. Feeling that things around you are
strange, unreal or foggy 0 1 2 3
3. Feeling detached from all or part of
your body 0 1 2 3
4. Sudden, unexpected panic spells 0 1 2 3
5. Apprehension or sense of impending
doom 0 1 2 3
6. Feeling tense, stressed, “uptight” or
on edge 0 1 2 3
Category II: Anxious Thoughts
7. Difficulty concentrating 0 1 2 3
8. Racing thoughts or having your mind
jump from one thing to the next 0 1 2 3
9. Frightening fantasies or daydreams 0 1 2 3
10. Feeling that you’re on the verge of
losing control 0 1 2 3
11. Fears of cracking up or going crazy 0 1 2 3
12. Fears of fainting or passing out 0 1 2 3
13. Fears of physical illnesses or heart
attacks or dying 0 1 2 3
14. Concerns about looking foolish or
inadequate in front of others 0 1 2 3
15. Fears of being alone, isolated or
abandoned 0 1 2 3
16. Fears of criticism or disapproval 0 1 2 3
17. Fears that something terrible is about
to happen 0 1 2 3
Category III: Physical Symptoms
18. Skipping or racing or pounding of the
heart (palpitations) 0 1 2 3
19. Pain, pressure or tightness in the chest 0 1 2 3
20. Tingling or numbness in the fingers and
toes 0 1 2 3
21. Butterflies or discomfort in the stomach 0 1 2 3
22. Constipation or diarrhea 0 1 2 3
23. Restlessness or jumpiness 0 1 2 3
24. Tight or tense muscles 0 1 2 3
25. Sweating not due to the heat 0 1 2 3
26. A lump in the throat 0 1 2 3
27. Trembling or shaking 0 1 2 3
28. Rubbery or “jelly” legs 0 1 2 3
29. Feeling dizzy, light-headed or off balance 0 1 2 3
30. Choking or difficulty breathing or tightness
in your chest 0 1 2 3
31. Headaches or pain in the back and neck 0 1 2 3
32. Hot flashes or cold chills 0 1 2 3
33. Feeling tired, weak or easily exhausted 0 1 2 3
Interpreting your anxiety score:
5 or below = minimal; 6-15 = mild; 16-30 = moderate; 31-50 = severe; over 50 = extreme
Please Contact Today For An Appointment: (818) 618-8830
Dr. Edward Giaquinto, Ph.D. - A licensed, clinical psychologist who has been assisting people in improving their life by increasing their emotional and mental health.