១.​ ខ្ញុំឃើញថា ខ្ញុំពិបាកសម្រួលអារម្មណ៍ឱ្យមកនៅធម្មតា
1- I found it hard to wind down

២. ខ្ញុំមានអារម្មណ៍ដឹងថាខ្ញុំមានអាការ:ស្ងួតមាត់
2- I was aware of dryness of my mouth

៣. ខ្ញុំហាក់ដូចជាមិនមានអារម្មណ៍វិជ្ជមានអ្វីបន្តិចសោះឡើយ
3- I couldn't seem to experience any positive feeling at all

៤. ខ្ញុំពិបាកដកដង្ហើម (ឧទាហរណ៍: ដកដង្ហើមញាប់ ឬចង់ផុតដង្ហើមទោះមិនបានហាត់ប្រាណក៏ដោយ)
4- I experienced breathing difficulty (eg, excessively rapid breathing, breathlessness in the absence of physical exertion)

៥. ខ្ញុំមានការពិបាកក្នុងការបង្កើតគំនិតផ្តួចផ្តើមទៅធ្វើអ្វីមួយ
5- I found it difficult to work up the initiative to do things

៦. ខ្ញុំហាក់ដូចជាមានប្រតិកម្មខ្លាំងជ្រុលទៅនឹងស្ថានការណ៍ដែលបានកើតឡើង
6- I tended to over-react to situations

៧. ខ្ញុំមានអាការៈញ័រៗ (ឧទាហរណ៍ ញ័រដៃ)
7- I experienced trembling (eg, in the hands)

៨. ខ្ញុំមានអារម្មណ៍ថា ខ្ញុំបានប្រើថាមពលរបស់ខ្ញុំជាច្រើនលើភាពជ្រួលច្របល់
8- I felt that I was using a lot of nervous energy

៩. ខ្ញុំព្រួយបារម្មណ៍ពីស្ថានភាពដែលអាចនាំឱ្យខ្ញុំមានបញ្ហាភ័យស្លន់ស្លោ ហើយអាចឱ្យខ្ញុំទៅជាបាត់បង់ការគ្រប់គ្រងចំពោះខ្លួនឯង
9- I was worried about situations in which I might panic and make a fool of myself

១០. ខ្ញុំមានអារម្មណ៍ថាខ្ញុំគ្មានអ្វីសម្រាប់ជាទីពឹងនៅអនាគត
10- I felt that I had nothing to look forward to

១១. ខ្ញុំឃើញថា ខ្ញុំកាន់តែមានអារម្មណ៍ឡេះឡះឡើង (នៅមិនសុខ)
11- I found myself getting agitated

១២. ខ្ញុំឃើញថា ខ្ញុំពិបាកក្នុងការបន្ធូរអារម្មណ៍
12- I found it difficult to relax

១៣. ខ្ញុំមានអារម្មណ៍ស្រងូតស្រងាត់ និងធ្លាក់ទឹកចិត្ត
13- I felt down-hearted and blue

១៤. ខ្ញុំមិនអាចអត់ធ្មត់ចំពោះអ្វីដែលរារាំងខ្ញុំមិនឱ្យធ្វើអ្វីដែលខ្ញុំកំពុងតែធ្វើទេ
14- I was intolerant of anything that kept me from getting on with what l was doing

១៥. ខ្ញុំមានអារម្មណ៍ ថាខ្លួនខ្ញុំជិតនឹងមានបញ្ហាភ័យស្លន់ស្លោ (គាំងដួល)
15- I felt l was close to panic

១៦. ខ្ញុំមិនអាចរីករាយជាមួយអ្វីៗទាំងអស់បានទេ
16- I was unable to become enthusiastic about anything

១៧. ខ្ញុំមានអារម្មណ៍ថាខ្ញុំមិនមានតម្លៃជាមនុស្សទេ
17- I felt I wasn't worth much as a person

១៨. ខ្ញុំមានអារម្មណ៍ថាខ្ញុំឆាប់ខឹង
18- I felt that I was rather touchy

១៩. ខ្ញុំបានដឹងថាចង្វាក់បេះដូងរបស់ខ្ញុំលោតញាប់ទោះបីជាខ្ញុំមិនធ្វើលំហាត់ប្រាណក៏ដោយ (បេះដូងដើរញាប់ បេះដូងលោតមិនទៀង)
19- I was aware of the action of my heart in the absence of physical exertion (eg, sense of heart rate increase, heart missing a beat)

២០. ខ្ញុំមានអារម្មណ៍ភ័យខ្លាចដោយគ្មានមូលហេតុត្រឹមត្រូវ
20- I felt scared without any good reason

២១. ខ្ញុំមានអារម្មណ៍ថាជីវិតគ្មានន័យ
21- I felt that life was meaningless

I found it hard to wind down

I had difficulty in swallowing

I couldn't seem to get any enjoyment out of the things I did

I was aware of the action of my heart in the absence of physical exertion (e.g. sense of heart rate increase, heart missing a beat)

I felt down-hearted and blue

I found that I was very irritable

I felt I was close to panic

I found it hard to calm down after something upset me

I feared that I would be "thrown" by some trivial but unfamiliar task

I was unable to become enthusiastic about anything

I found it difficult to tolerate interruptions to what I was doing

I was in a state of nervous tension

I felt I was pretty worthless

I was intolerant of anything that kept me from getting on with what I was doing

I felt terrified

I could see nothing in the future to be hopeful about

I felt that life was meaningless

I found myself getting agitated

I was worried about situations in which I might panic and make a fool of myself

I experienced trembling (eg., in the hands)

I found it difficult to work up the initiative to do things