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. 2017 Jul 20;5(3):e20. doi: 10.2196/medinform.6808

Table 1.

List of items in the social anxiety questionnaire administered by the example patient.

Item number Item text, prefixed by “Since the last assessment, I have...”
1 Felt moments of sudden terror, fear, or fright in social situations.
2 Felt anxious, worried, or nervous about social situations.
3 Had thoughts of being rejected, humiliated, embarrassed, ridiculed or offending others.
4 Felt a racing heart, sweaty, trouble breathing, faint, or shaky in social situations.
5 Felt tense muscles, felt on edge or restless, or had trouble relaxing in social situations.
6 Avoided, or did not approach or enter, social situations.
7 Left social situations early or participated only minimally (eg, said little or avoided eye contact)
8 Spent a lot of time preparing what to say or how to act in social situations.
9 Distracted myself to avoid thinking about social situations.
10 Needed help to cope with social situations (eg, with alcohol, medications, or superstitious objects).