Take the Social Anxiety Disorder Screening

The following is a self assessment. No data will be collected. This is just for your information.

1. This measure assesses the way that social phobia plays a role in your life across a variety of situations.

2. Read each situation carefully and answer two questions about that situation.

3. The first question asks how anxious or fearful you feel in the situation.

4. The second question asks how often you avoid the situation.

5. If you come across a situation that you ordinarily do not experience, we ask that you imagine "what if you were faced with that situation," and then rate the degree to which you would fear this hypothetical situation and how often you would tend to avoid it. Please base your ratings on the way that the situations have affected you in the last week.

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Situation	Fear				Avoidance
	None	Mild	Moderate	Severe	Never	Occasionally	Often	Usually
1. Using a Telephone in Public
2. Participating in a Small Group Activity
3. Eating in Public
4. Drinking with Others
5. Talking to Someone in Authority
6. Acting, Performing, or Speaking in Front of an Audience
7. Going to a Party
8. Working While Being Observed
9. Writing While Being Observed
10. Calling Someone You Don't Know Very Well
11. Talking Face to Face With Someone You Don't Know Very Well
12. Meeting Strangers
13. Urinating in a Public Bathroom
14. Entering a Room When Others are Already Seated
Situation	Fear				Avoidance
15. Being the Center of Attention
16. Speaking Up at a Meeting
17. Taking a Test of Your Ability, Skill, or Knowledge
18. Expressing Disagreement or Disapproval to Someone You Don't Know Very Well
19. Looking Someone Who You Don't Know Very Well Straight in the Eyes
20. Giving a Prepared Oral Talk to a Group
21. Trying to Make Someone's Acquaintance for the Purpose of a Romantic/Sexual Relationship
22. Returning Goods to a Store for a Refund
23. Giving a Party
24. Resisting a High Pressure Sales Person

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Contact Us Center for Anxiety and Traumatic Stress Disorders & Complicated Grief Program Massachusetts General Hospital, Boston, MA Phone: 1-866-44-WORRY email: anxietystudy@partners.org