Please choose the answer that best describes how much the following problems have bothered you during the past week. Check on the box for each problem and be sure to answer all the items.

 

Not at all
0

A little bit
1

Somewhat
2

Very much
3

Extremely
4

1.

Fear of embarrassment causes me to avoid doing things or speaking to people.

2.

I avoid activities in which I am the center of attention

3.

Being embarrassed or looking stupid are among my worse fears