INTRODUCTION
Below are sample questions taken from the PAQ, which is a questionnaire about panic attacks . The original questionnaire is 9-page long, so here you will find only an abbreviated version.
It will help you assess the frequency and severity of your panic attacks. Take it once a month together while working on your recovery to track your progress.
This tool is not a substitute for a medical diagnosis, as it is only informative.
INSTRUCTIONS
In this questionnaire we will ask you questions about panic attacks and your history of anxiety problems.
A panic attack is the sudden onset of intense fear or terror, often associated with feelings of impending doom that is not a result of a real danger. Some of the most common symptoms experienced during an attack are: dizziness, shortness of breath, chest pain or discomfort, and trembling or shaking. A panic attack differs from feelings of fear, anxiety, or worry that build up over time, and also differs from moderate feelings of fear or anxiety. Rather, it involves quick hitting feelings of extreme terror or fear.
PAQ
In the PAST YEAR approximately how many panic attacks have you had?
1 2 3 4 5 6 7 8 9 10 over 10
In the PAST FOUR WEEKS how many panic attacks have you had?
1 2 3 4 5 6 7 8 9 10 over 10
In the PAST WEEK how many panic attacks have you had?
1 2 3 4 5 6 7 8 9 10 over 10
Have panic attacks occurred MORE frequently at some time in the past?
YES _ NO _
Do you think the panic attacks are becoming more frequent?
YES _ NO _
Do you think the panic attacks are becoming more intense?
YES _ NO _
When a panic attack occurs, generally what is the time, speed between the onset of the attack and when the panic is most intense? Please again make rating for your most recent panic, the worst panic you can remember, and your typical or usual panic attacks:
~ Most Recent Panic Attack
a) very rapid (less than 10 minutes)
b) moderately rapid (10 – 30 minutes)
c) moderately slow (30 – 60 minutes)
d) slowly (more than one hour)
~ Worst Ever Panic Attack
a) very rapid (less than 10 minutes)
b) moderately rapid (10 – 30 minutes)
c) moderately slow (30 – 60 minutes)
d) slowly (more than one hour)
~ Typical/Usual Panic Attack
a) very rapid (less than 10 minutes)
b) moderately rapid (10 – 30 minutes)
c) moderately slow (30 – 60 minutes)
d) slowly (more than one hour)
How long, on average, does a panic attack last (start to finish)? Make rating for your most recent panic, the worst panic you can remember, and your typical or usual panic attacks:
~ Most Recent Panic Attack
a) a few minutes (0-10 minutes)
b) 10 – 30 minutes
c) 30 minutes to one hour
d) several hours
e) more than one day
~ Worst Ever Panic Attack
a) a few minutes (0-10 minutes)
b) 10 – 30 minutes
c) 30 minutes to one hour
d) several hours
e) more than one day
~ Typical/Usual Panic Attack
a) a few minutes (0-10 minutes)
b) 10 – 30 minutes
c) 30 minutes to one hour
d) several hours
e) more than one day
Please indicate how severely you experience each of the following symptoms WHEN YOU ARE HAVING a panic attack.
Remember: A panic attack is the sudden onset of intense fear or terror, often associated with feelings of impending doom. Please rate how severe each symptom was during your most recent panic attack, the worst panic attack you can remember, and you usual or typical panic attacks:
Use the following scoring: Doesn’t occur: 0, Mild: 1, Moderate: 2, Severe:3, Very severe: 4
a) Difficulty breathing
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
b) Neck tension
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
c) Heart pounding
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
d) Chest pain or discomfort
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
e) Joint pain
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
f) Choking or smothering sensations
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
g) Dizziness, vertigo, or unsteady feelings
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
h) Feelings of unreality
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
i) Tingling in hands or feet
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
j)Headache
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
k) Hot and cold flashes
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
l) Sweating
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
m) Acute neck pain
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
n) Faintness
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
o) Trembling or shaking
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
p) Cold extremities
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
q) Tinnitus/ringing in the ears
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
r) Fears of death or serious illness
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
s) Fear of going crazy
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
t) Fear of doing something uncontrolled
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
u) Feeling of nausea
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
v) Visual difficulties (e.g. blurred vision)
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
w) Auditory difficulties (e.g. ears ringing)
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
x) Difficulty concentrating
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
y) Extremely rapid heartbeat
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
z) Fear of causing a scene
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
aa) Feeling of anger
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
bb) Feeling of sadness
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
cc) Feeling of guilt
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
dd) Urge to escape from scene of the panic
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
ee) Flushing
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
ff) Fear of drawing attention to oneself
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
gg) Mouth feels dry
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
hh) Feeling of helplessness
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
ii) Neck soreness
Most recent panic: 0 1 2 3 4
Worst ever panic: 0 1 2 3 4
Typical/Usual panic: 0 1 2 3 4
How much control do you think you have in preventing the OCCURRENCE of any panic attack?(Please circle a number)
No Control: 0-3
Some Control: 4-7
Total Control: 8-10
How much control do you think you have in limiting the SEVERITY of any panic attack? (Please circle a number)
No Control: 0-3
Some Control: 4-7
Total Control: 8-10
How much distress do the panic attacks cause in your life?
None At All: 1
Mildly Distressing: 2
Moderately Distressing: 3
Very Distressing: 4
Extremely Distressing: 5
To what degree have the panic attacks caused you to change or restrict your lifestyle (e.g. everyday activities, places you go)?
No change: 1
Some change: 2
A moderate amount of change: 3
Quite a bit of change: 4
Extreme change: 5
SOURCES
Norton, G. R., Harrison, B., Hauch, J., & Rhodes, L. . (2012) . The Panic Attack Questionnaire . Measurement Instrument Database for the Social
One Response
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