Anxiety Inventory

Instructions:
Put a check (v) to indicate how much each system has bothered you in the past several days.
*Please answer all 25 items

0
Not At all

1
Sometimes

2
Moderately

3
A Lot

4
Extremely

Anxious Feeling

1.Anxiety, nervousness, worry or fear

2. Feeling things around you are strange or foggy

3. Sudden unexpected panic spells

4. Apprehension or a sense of impending doom

5. Feeling tense, stressed, ‘uptight’ or an edge

Anxious Thoughts

6. Difficultly concentrating

7. Racing thoughts

8. Frightening fantasies or daydreams

9. Feeling on the verge of losing control

10. Fears of cracking up or going crazy

11. Fear of fainting or passing out

12. Fears of illnesses, hear attacks or dying

13. Fears that something terrible will happen

Anxious Physical Symptoms

14. Skipping, racing or pounding of the heart

15. Pain or tightness in the chest

16. Tingling or numbness in the toes or fingers

17. Butterflies or discomfort in the stomach

18. Restlessness or jumpiness

19. Tight, tense muscles

20. Sweating not brought on by heat

21. Trembling or shaking

22. Rubber or ‘jelly’ legs

23. Feeling dizzy, lightheaded or off balance

24. Hot flashes or cold chills

25. Feeling tired, weak or easily exhausted

Relaxed with no anxiety

Normal but slightly nervous

Mild anxiety- You may be suffering from mild degrees of anxiety. If you find your health, daily life or working efficiency are being affected by your emotion, you should seek help from a mental health professional as soon as possible.

Moderate anxiety- You may be suffering from moderate degrees of anxiety. If you find your health, daily life or working efficiency are being affected by your emotion, you should seek help from a mental health professional as soon as possible.

Severe anxiety- You may be suffering from severe degrees of anxiety. If you find your health, daily life or working efficiency are being affected by your emotion, you should seek help from a mental health professional as soon as possible.

Extreme anxiety or panic- You may be suffering from extreme degrees of anxiety. If you find your health, daily life or working efficiency are being affected by your emotion, you should seek help from a mental health professional as soon as possible.