01732 808 626 info@thinkcbt.com

01732 808 626 info@thinkcbt.com

01732 808 626 info@thinkcbt.com

Panic and Agoraphobia Scale (PAS)
You can respond anonymously, and no data will be retained from this assessment. If you choose to include your initials and an email address, your results will be automatically sent to the email address provided. Please check that the email address has been entered correctly before submitting this form. All client information is managed on a strictly confidential basis. Please Note: Whilst every effort is made to ensure that our system is securely encrypted, email is not a completely secure means of communication. Think CBT does not accept liability for loss or theft of personal data where any individual chooses to transmit or receive information via email.
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This questionnaire is not designed to provide a definitive psychological diagnosis or to take the place of a professional consultation. Please answer all questions as accurately and honestly as possible.

What are Panic Attacks?

Panic attacks are sudden outbursts of anxiety, accompanied by one or more of the following symptoms:

• palpitations, pounding heart, or increased heart rate
• sweating
• trembling or shaking
• dry mouth
• difficulty breathing
• feeling of choking
• chest pain or discomfort
• nausea or abdominal distress (churning in stomach)
• feeling dizzy, unsteady, faint, or light-headed
• feelings that objects are unreal (like in a dream)
• fear of losing control, "going crazy," or passing out
• fear of dying
• hot flushes or cold chills
• numbness, or tingling sensations

Panic attacks develop suddenly and increase in intensity within about 10 minutes.

The PAS is a measure of the severity of illness in patients with panic disorder (with or without agoraphobia) over the past week. It is available in both clinician-administered and self-rating formats. It contains 5 sub-scales: panic attacks, agoraphobic avoidance, anticipatory anxiety, disability, and functional avoidance (health concerns).
This questionnaire is designed for people suffering from panic attacks and agoraphobia.

First, read the definition of panic attacks below; then rate the severity of your symptoms in the past week.

1. How frequently did you have panic attacks?

2. How severe were the panic attacks in the last week?

3. How long did the panic attacks last?

4. Were most of the attacks expected (occurring in feared situations) or unexpected (spontaneous)?

5. In the past week, did you avoid certain situations because you feared having a panic attack or a feeling of discomfort?

6. Please check the situation(s) you avoided or in which you developed panic attacks or a feeling of discomfort when you are not accompanied:

7. How important were the avoided situations?

8. In the past week, did you suffer from the fear of having a panic attack (anticipatory anxiety or “fear of being afraid)?”

9. How strong was this “fear of fear?”

10. In the past week, did panic attacks or agoraphobia lead to an impairment in your family relationships (partner, children, etc.)?

11. In the past week, did panic attacks or agoraphobia lead to an impairment of your social life and leisure activities (for example, you weren’t able to go to a film or party)?

12. In the past week, did panic attacks or agoraphobia lead to an impairment of your work or household responsibilities?

13. In the past week, did you worry about suffering harm from your panic attacks (for example, having a heart attack or fainting)?

14. Do you sometimes believe that your doctor was wrong when he told you your symptoms* have a psychological cause? Do you believe the actual cause of these symptoms is an undiscovered physical problem?

* (like rapid heart rate, tingling sensations, or shortness of breath)