Beck Anxiety Inventory (BAI)
About: This scale is a self-report measure of anxiety.

Reliability: Internal consistency for the BAI = (Cronbach’s a=0.92)
Test-retest reliability (1 week) for the BAI = 0.75 (Beck, Epstein, Brown, & Steer, 1988)

Validity: The BAI was moderately correlated with the revised Hamilton Anxiety Rating Scale (.51),
and mildly correlated with the Hamilton Depression Rating Scale (.25) (Beck et al., 1988).

Scoring:
The total score is calculated by finding the sum of the 21 items.
Score of 0-21 = low anxiety
Score of 22-35 = moderate anxiety
Score of 36 and above = potentially concerning levels of anxiety
Sign in to Google to save your progress. Learn more
Full Name *
Phone Number *
INSTRUCTIONS: This scale is designed for your personal use. There are no right or wrong answers. Usually your first response is the best. Please print these pages out for your personal use. You may also bring this assessment with you to your appointment and discuss the findings during your visit.
Below is a list of common symptoms of anxiety. Please carefully read each item in the list. Indicate how much you have been bothered by that symptom during the past month, including today.
0 - Not at all | 1 - Mildly, but it didn't bother me much | 2 - Moderately, it wasn't pleasant at times | 3 - Severely, it bothered me a lot
Numbness or tingling
Not At All
Severely - it bothers me a lot
Clear selection
Feeling Hot
Not At All
Severely - it bothers me a lot
Clear selection
Wobbliness in legs
Not At All
Severely - it bothers me a lot
Clear selection
Unable to relax
Not At All
Severely - it bothers me a lot
Clear selection
Fear of worst happening
Not At All
Severely - it bothers me a lot
Clear selection
Dizzy or lightheaded
Not At All
Severely - it bothers me a lot
Clear selection
Heart pounding/racing
Not At All
Severely - it bothers me a lot
Clear selection
Unsteady
Not At All
Severely - it bothers me a lot
Clear selection
Terrified or afraid
Not At All
Severely - it bothers me a lot
Clear selection
Nervous
Not At All
Severely - it bothers me a lot
Clear selection
Feeling of choking
Not At All
Severely - it bothers me a lot
Clear selection
Hands trembling
Not At All
Severely - it bothers me a lot
Clear selection
Shaky/ unsteady
Not At All
Severely - it bothers me a lot
Clear selection
Fear of losing control
Not At All
Severely - it bothers me a lot
Clear selection
Difficulty in breathing
Not At All
Severely - it bothers me a lot
Clear selection
Fear of dying
Not At All
Severely - it bothers me a lot
Clear selection
Scared
Not At All
Severely - it bothers me a lot
Clear selection
Indigestion
Not At All
Severely - it bothers me a lot
Clear selection
Faint/ lightheaded
Not At All
Severely - it bothers me a lot
Clear selection
Face flushed
Not At All
Severely - it bothers me a lot
Clear selection
Hot/cold sweats
Not At All
Severely - it bothers me a lot
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms