Anxiety State Self-Assessment Questionnaire

I. What is Anxiety?

Anxiety is a common emotional experience characterized by tension, worry, and unease about potential threats or uncertain events. While moderate anxiety can help us stay alert and cope with challenges, excessive or prolonged anxiety may affect daily life and physical and mental well-being.

II. Common Manifestations of Anxiety

Anxiety typically manifests across three levels of symptoms:

• Emotional Level: Tension, worry, fear, restlessness, irritability
• Physical Level: Palpitations, chest tightness, shortness of breath, dizziness, sweating, trembling, stomach discomfort, sleep disturbances
• Cognitive Level: Difficulty concentrating, memory decline, excessive worry about the future, catastrophic thinking

III. Purpose of the Questionnaire

This questionnaire is designed to help you understand your recent anxiety state. Through 20 simple self-assessment items, you can:

• Gain an initial understanding of the severity of your anxiety symptoms
• Identify the main dimensions of anxiety manifestation (emotional, physical, cognitive)
• Obtain a reference for whether professional help may be needed
• Track emotional changes during intervention

IV. Target Population

This questionnaire is suitable for adolescents and adults aged 16 and above with basic reading comprehension skills. It is not suitable for individuals with severe cognitive impairment, psychosis, or those unable to understand the content of the questions.

Special Note: If you are currently experiencing severe emotional distress or have been diagnosed with an anxiety disorder, it is recommended to conduct the assessment under the guidance of a professional. The results of this questionnaire are for reference only.

V. Questionnaire Structure and Scoring

This questionnaire contains 20 items, each describing an anxiety-related feeling or behavior. Please select the option that best fits your actual experience over the past week (including today).

• Each item is rated on a 1-4 scale: Not at all or rarely (1 point), Some of the time (2 points), A good part of the time (3 points), Most or all of the time (4 points)
• Add the scores of all 20 items to obtain the total score (range: 20-80 points)
• The higher the total score, the more pronounced the anxiety symptoms

VI. Important Notes

• Not a Diagnostic Tool: This questionnaire cannot replace professional diagnosis by a psychiatrist or psychological counselor
• Subjectivity: Results are based on your subjective feelings and may be influenced by your current emotional state
• Symptom Overlap: Anxiety symptoms may overlap with depression, physical illnesses, and other issues. Please consider other information for a comprehensive assessment
• Recommendation to Seek Professional Help: If the results indicate moderate or severe anxiety tendencies, or if you are experiencing significant distress, it is recommended to consult a mental health professional promptly

VII. References

The items in this questionnaire reference general clinical descriptions of anxiety and typical symptom descriptions from psychology textbooks (such as Psychiatry (8th Edition), symptom descriptions in DSM-5 anxiety disorder diagnostic criteria, etc.). It was developed by the Butterfly Test team based on publicly available psychological knowledge frameworks and does not infringe upon the copyright of any specific scale.