Anxiety Questionnaire
I would like to ask you to take part in a research questionnaire on anxiety.
1. Please circle T for True and F for False 2. Make any comments you wish, and 3. Copy this form and its answers and email them back to drjoe@shentel.net, as part of a research and survey report I will make.
My stress relievers get me what I want. T F Comments__________________
_________________________________________________________________________
When I get anxious, I get angry. T F Comments________________________
________________________________________________________________________
When I get jealous, I get anxious. T F Comments______________________
________________________________________________________________________
Anxiety has a positive meaning for me. T F Comments____________________
_________________________________________________________________________
I am an optimist 98% of the time. T F Comments_____________________
________________________________________________________________________
People never make me upset. T F Comments_______________________________
________________________________________________________________________
I’d rather be a villain than a victim. T F Comments__________________
________________________________________________________________________
I forgive and forget. T F Comments__________________________________
_______________________________________________________________________
I give compliments not criticisms. T F Comments______________________
There are no losers in my life. T F Comments_________________________
________________________________________________________________________
Punishment never works. T F Comments____________________________
________________________________________________________________________
I remain calm when criticized or threatened. T F Comments____________
_______________________________________________________________________
My expectations cause my upsets. T F Comments______________________
_______________________________________________________________________
Anxiety is never caused by other people or circumstances. T F Comments_______________________________________________________
My beliefs come true. T F Comments_________________________________
_____________________________________________________________________
I am never upset for the reason I think. T F Comments_______________
________________________________________________________________________
I have many questions I cannot answer. T F Comments_________________
________________________________________________________________________
Other people can’t make me happy. T F Comments______________________
______________________________________________________________________
Everything happens for a reason. T F Comments________________________
______________________________________________________________________
Medication can get rid of anxiety. T F Comments_____________________
________________________________________________________________________
Anxiety is a disease T F Comments_________________________________
________________________________________________________________________
Anxiety is normal T F Comments______________________________________
________________________________________________________________________
Criticism and complaints get me what I want T F Comments______________
________________________________________________________________________
1. Please circle T for True and F for False 2. Make any comments you wish, and 3. Copy this form and its answers and email them back to drjoe@shentel.net, as part of a research and survey report I will make.
My stress relievers get me what I want. T F Comments__________________
_________________________________________________________________________
When I get anxious, I get angry. T F Comments________________________
________________________________________________________________________
When I get jealous, I get anxious. T F Comments______________________
________________________________________________________________________
Anxiety has a positive meaning for me. T F Comments____________________
_________________________________________________________________________
I am an optimist 98% of the time. T F Comments_____________________
________________________________________________________________________
People never make me upset. T F Comments_______________________________
________________________________________________________________________
I’d rather be a villain than a victim. T F Comments__________________
________________________________________________________________________
I forgive and forget. T F Comments__________________________________
_______________________________________________________________________
I give compliments not criticisms. T F Comments______________________
There are no losers in my life. T F Comments_________________________
________________________________________________________________________
Punishment never works. T F Comments____________________________
________________________________________________________________________
I remain calm when criticized or threatened. T F Comments____________
_______________________________________________________________________
My expectations cause my upsets. T F Comments______________________
_______________________________________________________________________
Anxiety is never caused by other people or circumstances. T F Comments_______________________________________________________
My beliefs come true. T F Comments_________________________________
_____________________________________________________________________
I am never upset for the reason I think. T F Comments_______________
________________________________________________________________________
I have many questions I cannot answer. T F Comments_________________
________________________________________________________________________
Other people can’t make me happy. T F Comments______________________
______________________________________________________________________
Everything happens for a reason. T F Comments________________________
______________________________________________________________________
Medication can get rid of anxiety. T F Comments_____________________
________________________________________________________________________
Anxiety is a disease T F Comments_________________________________
________________________________________________________________________
Anxiety is normal T F Comments______________________________________
________________________________________________________________________
Criticism and complaints get me what I want T F Comments______________
________________________________________________________________________
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