Please indicate how much the following problems have bothered you during the past week. Mark only one box for each problem, and be sure to answer all items.
* Required
1. I am afraid of people and authority. *
2. I am bothered by blushing in front of people. *
3. Parties and social events scare me. *
4. I avoid talking to people I don't know. *
5. Being criticized scares me a lot. *
6. Fear of embarrassment causes me to avoid doing things or speaking to people *
7. Sweating in front of people causes me distress. *
8. I avoid going to parties *
9. I avoid activities in which I am the center of attention *
10. Talking to strangers scares me *
11. I avoid having to give speeches *
12. I would do anything to avoid being criticized *
13. Heart palpitations bother me when I am around people *
14. I am afraid of doing things when people might be watching *
15. Being embarrassed or looking stupid is among my worst fears *
16. I avoid speaking to anyone in authority *
17. Trembling or shaking in front of others is distressing to me *