Over the last 2 weeks, how often have you been bothered by the following problems?
Feeling nervous, anxious or on edge
Not being able to stop or control worrying
Worrying too much about different things
Being so restless that it is hard to sit still
Becoming easily annoyed or irritable
Feeling afraid as if something awful might happen
Score 0-4: Minimal Anxiety
Score 5-9: Mild Anxiety
Score 10-14: Moderate Anxiety
Score greater than 15: Severe Anxiety
How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
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© 2006 Spitzer RL, Kroenke K, Williams JB, Löwe B.