APPQ

Name:__________________________ Date:_____________

Using the following scale, please rate the amount of fear that you think you would experience in
each of the situations listed below if they were to occur in the next week. Try to imagine
yourself actually doing each activity and how you would feel.

Fear Scale

0-------1--------2-------3--------4--------5--------6--------7--------8
no slight moderate marked extreme
fear fear fear fear fear

1. Talking to people ____ 15. Wearing striking clothes ____

2. Going through a car wash ____ 16. Possibility of getting lost ____

3. Playing vigorous sport 17. Drinking a strong cup of

on a hot day ____ coffee ____

4. Blowing up an airbed 18. Sitting in the center of

quickly ____ a cinema ____

5. Eating in front of others ____ 19. Running up stairs ____

6. Hiking on a hot day ____ 20. Riding on a subway ____

7. Getting gas at a dentist ____ 21. Speaking on the telephone ____

8. Interrupting a meeting ____ 22. Meeting strangers ____

9. Giving a speech ____ 23. Writing in front of others ____

10. Exercising vigorously 24. Entering a room full of

alone ____ people ____

11. Going long distances 25. Staying overnight away from

from home alone ____ home ____

12. Introducing yourself to 26. Feeling the effects of

groups ____ alcohol ____

13. Walking alone in 27. Going over a long, low

isolated areas ____ bridge ____

14. Driving on highways ____

© Centre for Emotional Health, Macquarie University, Sydney

www.ceh.mq.edu.au