Hamilton Anxiety Rating Scale (HAM-A) - Home of Beautiful Souls Foundation

Toolkits
- Suicide first aid kit
- Covid Mental Health Toolkit
Mental Health Services
About Us
- Our Family
Blogs
Programs
Testimonials

Toolkits
- Suicide first aid kit
- Covid Mental Health Toolkit
Mental Health Services
About Us
- Our Family
Blogs
Programs
Testimonials

Measure your Anxiety

Note, this form is a standardized psychological tool used to measure anxiety. It isn't meant for self-diagnosis and needs professional evaluation in a therapy session.

- Step 1 of 2

Name *

First

Last

Phone *

Email *

Age *

Instructions

Below is a list of phrases that describe certain feeling that people have. Rate the patients by finding the answer which best describes the extent to which he/she has these conditions. Select one of the five responses for each of the fourteen questions. 0 = Not present, 1 =Mild, 2= Moderate, 3 =Severe, 4= Very severe.

Anxious Mood *

0
1
2
3
4

Worries, anticipation of the worst, fearful anticipation, irritability.

2. Tension *

0
1
2
3
4

Feelings of tension, fatigability, startle response, moved to tears easily, trembling, feelings of restlessness, inability to relax

3. Fears *

0
1
2
3
4

Of dark, of strangers, of being left alone, of animals, of traffic, of crowds.

4. Insomnia *

0
1
2
3
4

Difficulty in falling asleep, broken sleep, unsatisfying sleep and fatigue on waking, dreams, nightmares, night terrors.

5. Intellectual *

0
1
2
3
4

Difficulty in concentration, poor memory.

6. Depressed mood *

0
1
2
3
4

Loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.

7. Somatic (muscular) *

0
1
2
3
4

Pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.

8. Somatic (muscular) *

0
1
2
3
4

Tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.

9. Cardiovascular symptoms *

0
1
2
3
4

Tachycardia, palpitations, pain in chest, throbbing of vessels, fainting feelings, missing beat.

10. Respiratory symptoms *

0
1
2
3
4

Pressure or constriction in chest, choking feelings, sighing, dyspnea.

11. Gastrointestinal symptoms *

0
1
2
3
4

Difficulty in swallowing, wind abdominal pain, burning sensations, abdominal fullness, nausea, vomiting, borborygmi, looseness of bowels, loss of weight, constipation.

12. Genitourinary symptoms *

0
1
2
3
4

Frequency of micturition, urgency of micturition, amenorrhea, menorrhagia, development of frigidity, premature ejaculation, loss of libido, impotence.

13. Autonomic symptoms *

0
1
2
3
4

Dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.

14. Behavior at interview *

0
1
2
3
4

Fidgeting, restlessness or pacing, tremor of hands, furrowed brow, strained face, sighing or rapid respiration, facial pallor, swallowing, etc.