Beck Anxiety Inventory

Expert Therapy

Beck Anxiety Inventory
Name*

First NameLast Name
Please select your last evaluation date.*

DayMonthYear
Date

01. Numbness or tingling*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

02. Feeling hot*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

03. Wobbliness in legs*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

04. Unable to relax*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

05. Fear of worst happening*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

06. Dizzy or lightheaded*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

07. Heart pounding/racing*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

08. Unsteady*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

09. Terrified or afraid*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

10. Nervous*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

11. Feeling of choking*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

12. Hands trembling*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

13. Shaky / unsteady*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

14. Fear of losing control*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

15. Difficulty in breathing*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

16. Fear of dying*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

17. Scared*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

18. Indigestion*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

19. Faint / lightheaded*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

20. Face flushed*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

21. Hot/cold sweats*

	0	1	2	3

0 is Not at all, 3 is It bothered me a lot

Score
Should be Empty: