| 0 Strongly Disagree | 1 Somewhat Disagree | 2 Neither Agree nor Disagree | 3 Somewhat Agree | 4 Strongly Agree | |
|---|---|---|---|---|---|
| 1. I keep track of my symptom levels | |||||
| 2. As soon as I awake, I worry I will have discomfort in my throat/ chest/ esophagus during the day | |||||
| 3. There is nothing I can do to reduce the intensity of my symptoms | |||||
| 4. These symptoms are terrible, and I think things are never going to get better | |||||
| 5. When I feel discomfort in my throat/ chest/ esophagus it frightens me | |||||
| 6. I am aware of sudden or temporary changes in my esophagus | |||||
| 7. These symptoms are awful, and they overwhelm me |
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