Over the last 2 weeks, how often have you been bothered by any of the following problems? Please circle your answers.
1. Feeling nervous, anxious, or on edge.
Not at all sure
Several days
Over half the days
Nearly every day
2. Not being able to stop or control worrying.
Not at all sure
Several days
Over half the days
Nearly every day
3. Worrying too much about different things.
Not at all sure
Several days
Over half the days
Nearly every day
5. Being so restless that it’s hard to sit still
Not at all sure
Several days
Over half the days
Nearly every day
6. Becoming easily annoyed or irritable.
Not at all sure
Several days
Over half the days
Nearly every day
7. Feeling afraid as if something awful might happen.
Not at all sure
Several days
Over half the days
Nearly every day