Panic Disorder Assessment DSM-5

During the past 7 days, how much (or how often) have you...

  1. felt moments of sudden terror, fear or fright, sometimes out of the blue (i.e., a panic attack)
  2. felt anxious, worried, or nervous about having more panic attacks
  3. had thoughts of losing control, dying, going crazy, or other bad things happening because of panic attacks
  4. felt a racing heart, sweaty, trouble breathing, faint, or shaky
  5. felt tense muscles, felt on edge or restless, or had trouble relaxing or trouble sleeping
  6. avoided, or did not approach or enter, situations in which panic attacks might occur
  7. left situations early, or participated only minimally, because of panic attacks
  8. spent a lot of time preparing for, or procrastinating about (putting off), situations in which panic attacks might occur
  9. distracted myself to avoid thinking about panic attacks
  10. needed help to cope with panic attacks (e.g., alcohol or medication, superstitious objects, other people)

If you are completing this assessment as part of our pre-assessment process, please include your initials so that we can identify your results. If you wish to receive a copy of your results by email, please also include your email address in the fields provided below:

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