Situation
Fear
Avoidance
1. Using a telephone in public
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
2. Taking part in a small group activity
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
3. Eating in public
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
4. Drinking with other people
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
5. Talking to someone in authority
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
6. Acting, performing or speaking in front of an audience
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
7. Going to a party
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
8. Working while being observed
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
9. Writing while being observed
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
10. Calling someone you don't know very well
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
11. Talking face to face with someone you don't know very well
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
12. Meeting strangers
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
13. Urinating in a public bathroom
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
14. Entering a room when others are already seated
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
15. Being the centre of attention
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
16. Speaking up at a meeting
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
17. Taking a test of your ability, skill, or knowledge
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
18. Expressing disagreement or disapproval to someone you don't know very well
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
19. Looking someone who you don't know very well straight in the eyes
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
20. Giving a prepared talk to a group of people
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
21. Trying to make someone's acquaintance for the purpose of a romantic / sexual relationship
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
22. Returning goods to a store for a refund
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
23. Giving a party
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
24. Resisting a 'high pressure' sales person
0 - None
1 - Mild
2 - Moderate
3 - Severe
0 - Never
1 - Occasionally
2 - Often
3 - Usually
Individual Scores