Adolescent GAD Anxiety

Severity Measure for Generalized Anxiety Disorder (Ages 11-17)
Name*
Current Age*
Please complete the following questions about yourself. When completing the questionnaire, please think about your domestic and work experiences as they are today, and do not dwell too long on each question.

In the past SEVEN (7) DAYS, I have ...*

	Never	Occasionally	Half of The Time	Most of The Time	All of The time
1. Felt moments of sudden terror, fear, or fright
2. Felt anxious, worried, or nervous.
3. Had thoughts of bad things happening, such as family tragedy, ill health, loss of a job, or accidents.
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 about which I worry.
7. Left situations early or participated only minimally due to worries.
8. Spent lots of time making decisions, putting off making decisions, or preparing for situations, due to worries
9. South reassurance from others due to worries.
10. Needed help to cope with anxiety (e.g., alcohol or medication, superstitious objects, or other people).

RAW SCORE

RAW SCORE RATING INTERPRETATIONS

≤ 10: None to Slight

11-19: Mild

20-30: Moderate

30+: Severe

Should be Empty: