| I have feelings of nervousness, tension, jangling nerves. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel dizzy, disconnected, faint or unreal. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel physically run down. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I get palpitations, tightness in the chest or butterflies in my stomach. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel emotional and cry easily. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I get aches, pains or symptoms that make me worry I am sick. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I suffer from upset stomach, constipation, diarrhoea. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I often eat too much, or too little especially when I feel stressed or depressed. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel irritable and bad tempered. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I sometimes need to smoke, drink alcohol, or take drugs to help me cope. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I worry that I am losing it, and feel out of control. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel short of breath even when resting. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I get a tightness in my arms, neck, chest or head. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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rarely |
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5
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Never |
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| My memory lets me down, and I cannot concerntrate or make decisions easily. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel exhausted. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel disinterested in my work or daily routine. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I avoid any situation that has a worry component and would rather escape from it. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I worry a lot. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I worry about my performance and feel I am not coping. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I lack self confidence. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I get headaches. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel life has let me down and is not worth living. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel that there is no future. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I have lost interest in my relationships and in sex. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I cannot fall asleep even though I am tired. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I frequently wake up from sleep and my sleep pattern is disrupted. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I constantly wake early even though I am tired. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I worry that something bad is around the corner. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel under immense strain but cannot talk to anyone about it. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I dont want to see my friends and want to be left alone. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I am obsessive about certain tasks. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I feel pessimistic about everything. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I hate my personal life. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I am unhappy at work. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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| I have sudden feelings of fear, panic. |
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1
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All the time |
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2
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Frequently |
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3
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Sometimes |
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4
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Rarely |
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5
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Never |
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