1.  My hands get cold and clammy ...................................
2.  There is a band of tension around my head ......................
3.  My neck is stiff and hurts when I move my head .................
4.  There is a lot of pain in the lower part of my back ............
5.  I feel as if I am not getting enough air .......................
6.  My chest muscles feel tight ....................................
7.  I get light-headed and feel dizzy ..............................
8.  I clench my jaws and/or grind my teeth .........................
9.  I have cramping and pain in my stomach .........................
10. It often feels as if my blood pressure was up ..................
11. I get angry over nothing .......................................
12. I have trouble remembering names and appointments ..............
13. I feel depressed often .........................................
14. I don't remember what I read ...................................
15. I tell myself what I should do and then don't do it ............
16. I remember errors and ignore successes .........................  
17. I feel as if I can't change the bad things in my life ..........
18. I feel tired and fatigued ......................................
19. I feel responsible for the bad things that happen to others ....
20. I get irritated when my plans don't work out ...................
21. I yell at others for no good reason ............................
22. Meeting strange people gets me upset ...........................
23. I have trouble telling others what I want ......................
24. I get upset when others praise me ..............................
25. I feel alienated from my family ................................
26. My friends seem more successful than I am ......................
27. I never know what to do with aggressive people .................
28. I have trouble giving other people negative feedback ...........
29. I have difficulty expressing differences of opinion to others ..
30. I am impatient with other people ...............................