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 *