Preview Mode — This form cannot be filled outCreate Account

When Your Client or Parent Completes the Form, the System Generates a Chart Automatically

You'll see a report like the one below. T-scores, subscale analyses, and charts are calculated automatically.

Subscale Results

SubscaleRawT ScoreStatus
A1062.6Normal
Y960.9Normal
P449.8Normal
S2381.0Clinical
O964.2Normal
D652.8Normal
Total Anxiety5572.2Clinical
Total Internalising6169.2Borderline

Scale Results Chart

Age: 10Sex: Girl
Normal
Borderline
Clinical

Responses

All 47 answered items

1

I worry about things

Often
2

I feel sad or empty

Sometimes
3

When I have a problem, I get a funny feeling in my stomach

Sometimes
4

I worry when I think I have done poorly at something

Always
5

I would feel afraid of being on my own at home

Sometimes
6

Nothing is much fun anymore

Never
7

I feel scared when I have to take a test

Often
8

I feel worried when I think someone is angry with me

Always
9

I worry about being away from my parents

Often
10

I get bothered by bad or silly thoughts or pictures in my mind

Often
11

I have trouble sleeping

Sometimes
12

I worry that I will do badly at my school work

Often
13

I worry that something awful will happen to someone in my family

Often
14

I suddenly feel as if I can't breathe when there is no reason for this

Never
15

I have problems with my appetite

Never
16

I have to keep checking that I have done things right (like the switch is off, or the door is locked)

Often
17

I feel scared if I have to sleep on my own

Sometimes
18

I have trouble going to school in the mornings because I feel nervous or afraid

Often
19

I have no energy for things

Sometimes
20

I worry I might look foolish

Always
21

I am tired a lot

Sometimes
22

I worry that bad things will happen to me

Sometimes
23

I can't seem to get bad or silly thoughts out of my head

Sometimes
24

When I have a problem, my heart beats really fast

Sometimes
25

I cannot think clearly

Never
26

I suddenly start to tremble or shake when there is no reason for this

Never
27

I worry that something bad will happen to me

Often
28

When I have a problem, I feel shaky

Sometimes
29

I feel worthless

Sometimes
30

I worry about making mistakes

Often
31

I have to think of special thoughts (like numbers or words) to stop bad things from happening

Sometimes
32

I worry what other people think of me

Always
33

I am afraid of being in crowded places (like shopping centers, the movies, buses, busy playgrounds)

Sometimes
34

All of a sudden I feel really scared for no reason at all

Never
35

I worry about what is going to happen

Sometimes
36

I suddenly become dizzy or faint when there is no reason for this

Never
37

I think about death

Sometimes
38

I feel afraid if I have to talk in front of my class

Often
39

My heart suddenly starts to beat too quickly for no reason

Sometimes
40

I feel like I don't want to move

Never
41

I worry that I will suddenly get a scared feeling when there is nothing to be afraid of

Never
42

I have to do some things over and over again (like washing my hands, cleaning or putting things in a certain order)

Often
43

I feel afraid that I will make a fool of myself in front of people

Always
44

I have to do some things in just the right way to stop bad things from happening

Sometimes
45

I worry when I go to bed at night

Often
46

I would feel scared if I had to stay away from home overnight

Sometimes
47

I feel restless

Sometimes

Create your own test

Sign up for free and send test links to your clients.

Get StartedHow the Test Looks