| Yes |
No |
|
|
| Panic Disorder |
|
|
1. |
Did you experience a sudden unexplained attack of intense
fear, anxiety, or panic for no apparent reason? (If "yes," continue with
questions a-c; if "no," go to question 2.) |
|
|
|
a. Were you afraid you might have more of these
attacks? |
|
|
|
b. Were you worried that these attacks could mean you were
losing control, having a heart attack, or "going crazy"? |
|
|
|
c. Did these attacks cause changes or avoidance patterns in
your behavior? |
|
|
2. |
Have you been afraid of not being able to get help or not
being able to escape in certain situations, such as being on a bridge, in
a crowded store, or in similar situations? |
|
|
3. |
Have you been afraid or unable to travel
alone?
|
| Yes |
No |
|
|
| Generalized anxiety disorder |
|
|
4. |
Have you persistently worried about several different
things, such as work, school, family, and money? |
|
|
5. |
Did you find it difficult to control your worrying? |
|
|
6. |
Did persistent worrying or nervousness cause problems with
your work or your dealings with people?
|
| Yes |
No |
|
|
| Obsessive-compulsive disorder |
|
|
7. |
Did you have persistent, senseless thoughts you could not
get out of your head, such as thoughts of death, illnesses, aggression,
sexual urges, contamination, or others? |
|
|
8. |
Did you spend more time than necessary doing things over
and over again, such as washing your hands, checking things, or counting
things? |
|
|
9. |
Did you spend more than one hour a day involved in your
senseless thoughts or your needless checking, washing, or
counting?
|
| Yes |
No |
|
|
| Social phobia |
|
|
10. |
Were you afraid to do things in front of people, such as
public speaking, eating, performing, or teaching? |
|
|
11. |
Did you avoid or feel very uncomfortable in situations
involving people, such as parties, weddings, dating, dances, and other
social events?
|
| Yes |
No |
|
|
| Post-traumatic stress disorder |
|
|
1. |
Have you ever had an extremely frightening, traumatic, or
horrible experience--such as being the victim of a violent crime, being
seriously injured in a car crash, being sexually assaulted, seeing someone
seriously injured or killed, or being the victim of a natural disaster?
(If "yes," continue with questions a-e.) |
|
|
|
a. Did you relive the experience through recurrent dreams,
preoccupations, or flashbacks? |
|
|
|
b. Did you seem less interested in important things, not
"with it," or unable to experience or express emotions? |
|
|
|
c. Did you have problems sleeping, concentrating, or
keeping your temper? |
|
|
|
d. Did you avoid anything that reminded you of the original
horrible event? |
|
|
|
e. Did you have some of the above problems for more than
one month? |