Instructions:

Check the word that shows how often each of these things happens to you. There are no right or wrong answers.
Never Sometimes Often Always

1 I worry about things 0 1 2 3

2 I feel sad or empty 0 1 2 3

3 When I have a problem, I get a funny feeling in my stomach 0 1 2 3

4 I worry when I think I have done poorly at something 0 1 2 3

5 I would feel afraid of being on my own at home 0 1 2 3

6 Nothing is much fun anymore 0 1 2 3

7 I feel scared when I have to take a test 0 1 2 3

8 I feel worried when I think someone is angry with me 0 1 2 3

9 I worry about being away from my parents 0 1 2 3

10 I get bothered by bad or silly thoughts or pictures in my mind 0 1 2 3

11 I have trouble sleeping 0 1 2 3

12 I worry that I will do badly at my school work 0 1 2 3

13 I worry that something awful will happen to someone in my family 0 1 2 3

14 I suddenly feel as if I can’t breathe when there is no reason or this 0 1 2 3

15 I have problems with my appetite 0 1 2 3

16 things right (like the switch is off, or the door is locked)

0 1 2 3

Never Sometimes Often Always

17 I feel scared if I have to sleep on my own 0 1 2 3

I have trouble going to school in the

18 mornings because I feel nervous or afraid

0 1 2 3

19 I have no energy for things 0 1 2 3

20 I worry I might look foolish 0 1 2 3

21 I am tired a lot 0 1 2 3

22 I worry that bad things will happen to me 0 1 2 3

23 I can’t seem to get bad or silly thoughts out of my head 0 1 2 3

24 When I have a problem, my heart beats really fast 0 1 2 3

25 I cannot think clearly 0 1 2 3

26 I suddenly start to tremble or shake when there is no reason for this 0 1 2 3

27 I worry that something bad will happen to me 0 1 2 3

29 I feel worthless 0 1 2 3

30 I worry about making mistakes 0 1 2 3

I have to think of special thoughts (like

31 numbers or words) to stop bad things from happening

0 1 2 3

32 I worry what other people think of me 0 1 2 3

I am afraid of being in crowded places

33 (Like shopping centres, the movies,

buses, busy playgrounds) 0 1 2 3

34 All of a sudden, I feel really scared for no reason at all 0 1 2 3

35 I worry about what is going to happen 0 1 2 3

36 I suddenly become dizzy or faint when there is no reason for this 0 1 2 3

Never Sometimes Often Always

37 I think about death 0 1 2 3
38 I feel afraid if I have to talk in front of my class 0 1 2 3

39 My heart suddenly starts to beat too quickly for no reason 0 1 2 3

40 I feel like I don’t want to move 0 1 2 3

I worry that I will suddenly get a scared feeling when there is nothing

0 1 2 3
 I have to do some things over and over again (like washing my
42 hands, cleaning or putting things in a certain order)

0 1 2 3

43 I feel afraid that I will make a fool of myself in front of people 0 1 2 3

I have to do some things in just the right way to stop bad things from
44 happening

0 1 2 3

45 I worry when I go to bed at night 0 1 2 3

47 I feel restless 0 1 2 3

A Total Anxiety Scale score (sum of the 5 anxiety subscales) and a Total Internalizing Scale score (sum of all 6
subscales) are derived, with higher scores indicating increased symptom severity. In addition, items are summed to
obtain a total score for each of the six subscales. Subscale scores are converted into percentiles, based on age,
compared to the Australian community sample (de Ross et al., 2002). A percentile score of 50 represents average levels
of symptoms compared to age related peers, whereas a percentile above, for example, the 90th percentile indicates high
levels of symptoms. Sub-scales are computed by summing the following items: Separation Anxiety: items 5, 9, 17, 18,
33, 45, 46 Social Phobia: items 4, 7, 8, 12, 20, 30, 32, 38, 43 Generalized Anxiety: items 1, 13, 22, 27, 35, 37 Panic
Disorder: items 3, 14, 24, 26, 28, 34, 36, 39, 41 Obsessive-Compulsive: items 10,16, 23, 31, 42, 44 Major Depression:
items 2, 6, 11, 15, 19, 21, 25, 29, 40, 47