Agoraphobia Questionnaire

1. How anxious are you about being in a place and situation from which escape may be difficult or embarrasing
  Not at all   Sometimes   Most of the times
2. Do you experience anxiety about situations like
Being outside the home alone   No   Yes
Being in a crowd   No   Yes
Standing in a line (within a shop)   No   Yes
Traveling in a bus, train or car   No   Yes
Being on a bridge   No   Yes
Being in an elevator   No   Yes
3. How do you handle these fearful situations (Select most appropriate one)
Although it is stressful I handle these situations  
Need to be accompanied in such a situation  
Try to avoid such a situation  
Handle situation on my own but with great difficulty  
Avoid such a situation to such an extent that I can't carry out my normal responsibilities  

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