When I feel frightened, it is hard to breathe * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I get headaches when I am at school * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I don't like to be with people I don't know well * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I get scared if I sleep away from home * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I worry about other people liking me * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
When I get frightened, I feel like passing out * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I am nervous * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I follow my mother or father wherever they go * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
People tell me that I look nervous * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I feel nervous with people I don't know well * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I get stomachaches at school * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
When I get frightened, I feel like I am going crazy * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I worry about sleeping alone * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I worry about being as good as other kids * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
When I get frightened, I feel like things are not real * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I have nightmares about something bad happening to my parents * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I worry about going to school * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
When I get frightened, my heart beats fast * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I get shaky * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I have nightmares about something bad happening to me * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I worry about things working out for me * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
When I get frightened, I sweat a lot * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I am a worrier * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I get really frightened for no reason at all * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I am afraid to be alone in the house * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
It is hard for me to talk with people I don't know well * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
When I get frightened, I feel like I am choking * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
People tell me that I worry too much * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I don't like to be away from my family * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I am afraid of having anxiety (or panic) attacks * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I worry that something bad might happen to my parents * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I feel shy with people I don't know well * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I worry about what is going to happen in the future * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
When I get frightened, I feel like throwing up * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I worry about how well I do things * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I am scared to go to school * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I worry about things that have already happened * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
When I get frightened, I feel dizzy * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I feel nervous when I am with other children and I have to do something while they watch me * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I feel nervous when I am going to parties, dances, or any place where there will be people I don't know well * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)
I am shy * Select... Not true or hardly ever true (0) Somewhat true or sometimes true (1) Very true or often true (2)