CPRS Anxiety Test

Welcome to your CPRS Anxiety Test

What is your name?

Email Address

Where are you from?

Please describe your the degree in which you have worried about your life during the past three days. Consider how intense these feelings have been and if they have been consistently there.

0 = I am mostly calm

1

2 = Sometimes I worry and it makes me feel uncomfortable.

3

4 = I worry all the time. The feeling overwhelms me and I have to fight hard to control it.

5

6 = I am overcome with anxiety. The feeling is hard to bare and is always there.

Do you get irritated easily? How intense are your feelings of anger?

0 = I do not get irritated easily.

1

2 = I get irritated more easily than before but the feeling quickly subsides.

3

4 = I get angry more easily than before. Sometimes I lose control, which is not normal for me.

5

6 = I feel overcome with rage and often find it hard to control myself.

How well have you slept in the past three days. Please do not take into consideration the use of medications. If you sleep more than usual please mark the box at the bottom.

0 = I sleep well and long enough to meet my energy needs. I don't have any difficulty falling asleep.

1

2 = I have some problem falling asleep. Sometimes I feel as if I don't fall deep enough into my sleep.

3

4 = I sleep 2 hours less than usual. I wake up severals times during the night.

5

6 = I don't sleep well at all. 2-3 hours less than usual.

Do you worry about your health?

0 = I don't give it any thought.

1

2 = If something hurts or feels strange I automatically think that I have a disease.

3

4 = I have a strong suspicion that I have a disease, but I feel somewhat calm after seeing the doctor.

5

6 = I am convinced that I am sick and can't stop thinking about it.

Do you worry about little things? Are you worried about something before it has even happened or are you exceedingly anxious?

0 = I don't worry about little things.

1

2 = I worry even in cases it is not needed but it tends to go away easily.

3

4 = I worry often about things that I should not be worrying about.

5

6 = I am paralysed with worry and it doesn't seem to go away.

Do you suffer from any form of phobia?

0 = I have no form of phobia.

1

2 = I feel uncomfortable in certain situations but can easily overcome it and it doesn't hinder me.

3

4 = I feel very uncomfortable in certain situations and do my best to avoid them at all costs.

5

6 = I have phobias in every aspect of my life and I am unable to do anything.

Do you suffer from any discomfort of the body? i.e. heart-palpitations, excessive sweating, cold hands or feet, dryness of the mouth, gassy stomach etc.

0 = I don't have any such discomforts.

1

2 = When I am upset, I can feel butterflies in my stomach, heart-palpitations etc.

3

4 = I feel great discomfort in my body and find it worrying.

5

6 = I often feel great discomfort in my body and it affects my daily life.

Do you suffer from aches and pains of the body? How severe are they? Do you need to take painkillers? Please do not take into consideration pain or aches caused by injuries and sickness.

0 = I do not suffer from aches and pains of the body.

1

2 = Sometimes I suffer from aches and pains of the body.

3

4 = I suffer from lengthy aches and pains of the body and am often forced to take painkillers.

5

6 = My aches and pains are so intense that they stop me from living my life.

Have you suffered from panic attacks in the past three days? If so, how intense?

0 = I have not suffered from panic attacks in the past three days.

1

2 = I have felt as if I was about to have a panic attack but it did not happen.

3

4 = I have had several panic attacks during the past three days but have been able to cope by myself.

5

6 = I have had several panic attacks in the past three days that I have had to medicate to get rid of.