By going through the checklists below, you’ll
get a good idea of how your body and mind react to the fear
of disapproval, and about the range of social and performance
situations that you try to avoid. If you decide to seek help
from a physician or a therapist, bring this completed form
with you. It will provide the professional with much useful
information about you and your situation and may speed up
the assessment process.
I experience panic attacks, either
in social situations, or in anticipation of them:
(A panic attack is a sudden surge of intense
fear and anxiety, usually accompanied by several or many of
the above physical symptoms. It will usually reach a peak
in five to 20 minutes before subsiding.)
Yes
No
I’m especially likely to experience panic attacks
in these situations:
I experience panic attacks approximately
times per week.
