Cognitive Therapy of Anxiety Disorders

167

From Cognitive Therapy of Anxiety Disorders: Science and Practice by David A. Clark and Aaron T. Beck. Copyright
2010 by The Guilford Press. Permission to photocopy this appendix is granted to purchasers of this book for personal
use only (see copyright page for details).

aPPENDIX 5.5

Expanded Physical Sensations Checklist

Name: Date:

Instructions: below you will find a list of physical sensations that can be experienced during periods
of high anxiety or during panic attacks. Please indicate the intensity of the physical sensation during
a typical anxiety episode or panic attack. The checklist should be completed during the anxiety
episode or as soon afterward as possible. Also please circle the bodily reaction or sensation that
you noticed first during the episode of anxiety.

Physical Sensation absent Slight Moderate Severe

Very

Severe

Tense muscles

Muscle pain

Weakness

Muscle twitches, spasms

Numbness in hands, feet (or

pins and needles sensation)

Tingling in hands, feet

Nausea

Stomach cramps

Indigestion

Feeling of urgency to urinate

Diarrhea

Congested, buildup of mucus

in throat or nose

Dry mouth

(cont.)