SCARED-C

Directions:
Below is a list of sentences that describe how people feel. Read each phrase and decide if it is “NOT TRUE/HARDLY EVER TRUE”, “SOMEWHAT TRUE/SOMETIMES TRUE”, or “VERY TRUE/OFTEN TRUE” for you. Then, for each statement, select one circle that corresponds to the response that seems to describe you now or within the past 3 months.

Questions 1-20

Rows	Not True/Hardly Ever True	Somewhat True/Sometimes True	Very True/Often True
1. When I feel frightened, it is hard to breathe.
2. I get headaches when I am at school.
3. I don’t like to be with people I don’t know well.
4. I get scared if I sleep away from home.
5. I worry about other people liking me.
6. When I get frightened, I feel like passing out.
7. I am nervous.
8. I follow my mother or father wherever they go.
9. People tell me that I look nervous.
10. I feel nervous with people I don’t know well.
11. I get stomachaches at school.
12. When I get frightened, I feel like I am going crazy.
13. I worry about sleeping alone.
14. I worry about being as good as other kids.
15. When I get frightened, I feel like things are not real.
16. I have nightmares about something bad happening to my parents.
17. I worry about going to school.
18. When I get frightened, my heart beats fast.
19. I get shaky.
20. I have nightmares about something bad happening to me.

Questions 21-41

Rows	Not True/Hardly Ever True	Somewhat True/Sometimes True	Very True/Often True
21. I worry about things working out for me.
22. When I get frightened, I sweat a lot.
23. I am a worrier.
24. I get really frightened for no reason at all.
25. I am afraid to be alone in the house.
26. It is hard for me to talk with people I don't know well.
27. When I get frightened, I feel like I am choking.
28. People tell me that I worry too much.
29. I don't like to be away from my family.
30. I am afraid of having anxiety (or panic) attacks.
31. I worry that something bad might happen to my parents.
32. I feel shy with people I don't know well.
33. I worry about what is going to happen in the future.
34. When I get frightened, I feel like throwing up.
35. I worry about how well I do things.
36. I am scared to go to school.
37. I worry about things that have already happened.
38. When I get frightened, I feel dizzy.
39. I feel nervous when I am with other children or adults and I have to do something while they watch me (for example: read aloud, speak, play a game, play a sport).
40. I feel nervous when I am going to parties, dances, or any place where there will be people that I don't know well.
41. I am shy.

TOTAL: A total score of ≥ 25 may indicate the presence of an Anxiety Disorder. Scores higher than 30 are more specific.
PN: A score of 7 may indicate Panic Disorder or Significant Somatic Symptoms.
GD: A score of 9 may indicate Generalized Anxiety Disorder.
SP: A score of 5 may indicate Separation Anxiety Disorder.
SC: A score of 8 may indicate Social Anxiety Disorder.
SH: A score of 3 may indicate Significant School Avoidance.
Should be Empty:

Screen for Child Anxiety Related Emotional Disorders