Self-Report For Childhood Anxiety Related Disorders (Scared)
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2SELF-REPORT FOR CHILDHOOD ANXIETY RELATED DISORDERS
(SCARED)
CHILD FORM (8 years and older*)
Name:____________________________________
Date: _____________________
Identification #: ______________________
Below is a list of items that describe how people feel. For each item that describes you, please circle the 2 if the item is very true or often
true of you. Circle the 1 if the item is somewhat or sometimes true of you. If the item is not true of you, please circle the 0. Please
answer all items as well as you can, even if some do not seem to concern you.
0 = Not true or hardly ever true
1 = Somewhat true or sometimes true
2 = Very true or often true
1
When I feel frightened, it is hard to breathe.
0 1 2
2
I get headaches when I am at school.
0 1 2
3
I don’t like to be with people I don’t know well.
0 1 2
4
I get scared if I sleep away from home.
0 1 2
5
I worry about other people liking me.
0 1 2
6
When I get frightened, I feel like passing out.
0 1 2
7
I am nervous.
0 1 2
8
I follow my mother or father wherever they go.
0 1 2
9
People tell me that I look nervous.
0 1 2
10
I feel nervous with people I don’t know well.
0 1 2
11
I get stomach aches at school.
0 1 2
12
When I get frightened, I feel like I am going crazy.
0 1 2
13
I worry about sleeping alone.
0 1 2
14
I worry about being as good as other kids.
0 1 2
15
When I get frightened, I feel like things are not real.
0 1 2
16
I have nightmares about something bad happening to my parents.
0 1 2
17
I worry about going to school.
0 1 2
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