Buku-Ajar-Terapi-Bermain-Anak

25. Muscle tension or nonspecific tension. ______ ______ ______
26. Sleep disturbance, especially difficulty falling asleep. ______ ______ ______
27. Dread or fearful anticipation (nonspecific). ______ ______ ______
SPECIFIC PHOBIA
28. Animal: Specify _____________________________ ______ ______ ______
29. Natural environment:
(e.g., heights, storms) Specify: _____________________ ______ ______ ______
30. Blood-injection-injury: Specify: _________________ ______ ______ ______
31. Situational
(e.g., airplane, elevator): Specify: __________________ ______ ______ ______
ACUTE PHYSICAL SIGNS & SYMPTOMS
32. Blushing. ______ ______ ______
33. Feels paralyzed. ______ ______ ______
34. Trembling or shaking. ______ ______ ______
35. Feels dizzy, unsteady, lightheaded or going to pass out. ______ ______ ______
36. Palpitations or pounding heart. ______ ______ ______
37. Difficult breathing. ______ ______ ______
(sensation of shortness of breath, smothering or choking). ______ ______ ______
38. Chills or hot flashes. ______ ______ ______
39. Sweating. ______ ______ ______
40. Feels sick to stomach, nausea or abdominal distress. ______ ______ ______
41. Recurrent urge to go to bathroom. ______ ______ ______
42.Chest pain or discomfort. ______ ______ ______
43. Paresthesias
(numbness or tingling sensation in fingers, toes, or perioral region). ______ ______ ______
44. Problems swallowing or eating. ______ ______ ______
OTHER
45. Crying spells when in anxiety-provoking situations. ______ ______ ______
46. Temper tantrums when in anxiety-provoking situations. ______ ______ ______
47. Needs to flee certain anxiety-provoking situations. ______ ______ ______
48. Keeps distance from other people. ______ ______ ______
49. Fear of losing control or going crazy. ______ ______ ______
50. Derealization (feeling of unreality)
or depersonalization (detached from oneself). ______ ______ ______
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