Marriage and Family Therapy

Anxiety Check List

ANXIETY CHECKLIST
A. Feeling tense or anxious?
B. Worrying a lot about things?

If YES to any of the above, continue below
1. Symptoms of arousal and anxiety?
2. Experienced intense or sudden fear unexpectedly or for no apparent reason?

  • · Fear of dying
  • · Fear of losing control
  • · Pounding heart
  • · Sweating
  • · Trembling or shaking
  • · Chest pains or difficulty breathing
  • · Feeling dizzy, lighthearted or faint
  • · Numbness or tingling sensations
  • · Feelings of unreality
  • · Nausea

3. Experiences fear/anxiety in specific situations

  • · Leaving familiar places
  • · Travelling alone, eg train, car, plane
  • · Crowds confined places/public places

4. Experienced fear/anxiety in social situations

  • · Speaking in front of others
  • · Social events
  • · Eating in front of others
  • · Worry a lot about what others think or self-conscious?

Summing up
Positive to A, B and 1, recurring regularly, negative to 2, 3 and 4: Indication of
generalized anxiety
Positive to 1 and 2: indication of panic disorder
Positive to 2 and 3: indication of agoraphobia
Positive to 3 and 4: indication of social phobia

Original source: WHO Guide to Mental and Neurological Health in Primary Care

 

 

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