0 : No fear
1
2 : Slight fear
3
4 : Moderate fear
5
6 : Marked fear
7
8 : Extreme fear
¹
0
1
2
3
4
5
6
7
8
1
Talking to people.
2
Going through a car wash.
3
Playing a vigorous sport on a hot day.
4
Blowing up an airbed quickly.
5
Eating in front of others.
6
Hiking on a hot day.
7
Getting gas at a dentist.
8
Interrupting a meeting.
9
Giving a speech.
10
Exercising vigorously alone.
11
Going long distances from home alone.
12
Introducing yourself to groups.
13
Walking alone in isolated areas.
14
Driving on highways.
15
Wearing striking clothes.
16
Possibility of getting lost.
17
Drinking a strong cup of coffee.
18
Sitting in the center of a cinema.
19
Running up stairs.
20
Riding on a subway.
21
Speaking on the telephone.
22
Meeting strangers.
23
Writing in front of others.
24
Entering a room full of people.
25
Staying overnight away from home.
26
Feeling the effects of alcohol.
27
Going over a long, low bridge.
The presented answer sheet is not an original form and is not intended for printing or use as a handout.
The answer numbers are used only to label response columns. They are NOT scores and should not be used for calculating results.