Burns Anxiety Inventory

This questionnaire is not meant to diagnose, but rather to help you understand whether a certain mental health or relationship issue may be of concern to you. If you would like to print this out for your healthcare provider, you may do so by using the 'print' button at the end of the page.
Burns Anxiety Inventory

The following is a list of symptoms that people sometimes have. Put a check in the space to the right that best describes how much that symptom or problem has bothered you during the past week.

Category I: Feelings

Rows	Not at All	Sometimes	Moderately	A Lot
1. Anxiety, nervousness, worry or fear
2. Feeling that things around you are strange, unreal, or foggy
3. Feeling detached from all or part of your body
4. Sudden, unexpected panic spells
5. Apprehension or a sense of impending doom
6. Feeling tense, stressed, 'uptight' or on edge

Category II: Thoughts

Rows	Not at All	Sometimes	Moderately	A Lot
7. Difficulty concentrating
8. Racing thoughts or having your mind jump from one thing to the next
9. Frightening fantasies or daydreams
10. Feeling that you are on the verge of losing control
11. Fears of going crazy
12. Fears of fainting or passing out
13. Fears of physical illnesses, heart attacks, or dying
14. Concerns about looking foolish or inadequate in front of others
15. Concerns Fears of being alone, isolated, or abandoned
16. Fears of criticism or disapproval
17. Fears that something terrible is about to happen

Category III: Physical

Rows	Not at All	Sometimes	Moderately	A Lot
18. Skipping, racing or pounding of the heart
19. Pain, pressure or tightness in the chest
20. Tingling or numbness in the toes and fingers
21. Butterflies or discomfort in the stomach
22. Constipation or diarrhea
23. Restlessness/jumpiness
24. Tight, tense muscles
25. Sweating not brought on by heat
26. A lump in the throat
27. Trembling or shaking
28. Rubber or 'jelly' legs
29. Feeling dizzy, light-headed, or off balance
30. Choking/smothering sensations or difficulty breathing
31. Headache or pain in the neck/back
32. Hot flashes or cold chills
33. Feeling tired, weak, or easily exhausted