{"id":23358,"date":"2024-09-17T12:42:05","date_gmt":"2024-09-17T12:42:05","guid":{"rendered":"https:\/\/versionx.bronwynrusso.com\/?page_id=23358"},"modified":"2024-09-17T12:42:05","modified_gmt":"2024-09-17T12:42:05","slug":"beck-anxiety-inventory-bai","status":"publish","type":"page","link":"https:\/\/versionx.bronwynrusso.com\/?page_id=23358","title":{"rendered":"Beck Anxiety Inventory (BAI)"},"content":{"rendered":"<section data-bb-version=\"5.1.2\" id=\"bt_bb_section69d2c4b93123e\" class=\"bt_bb_section bt_bb_layout_boxed_1200\"  data-bt-override-class=\"null\"><div class=\"bt_bb_port\"><div class=\"bt_bb_cell\"><div class=\"bt_bb_cell_inner\"><div class=\"bt_bb_row \"  data-bt-override-class=\"{}\"><div class=\"bt_bb_row_holder\" ><div data-bb-version=\"5.1.2\"  class=\"bt_bb_column col-xxl-12 col-xl-12 col-xs-12 col-sm-12 col-md-12 col-lg-12 bt_bb_vertical_align_top bt_bb_align_left bt_bb_padding_normal\" style=\"; --column-width:12;\" data-width=\"12\" data-bt-override-class=\"{}\"><div class=\"bt_bb_column_content\"><div class=\"bt_bb_column_content_inner\"><div class=\"bt_bb_shortcode\"><div class=\"wpforms-container wpforms-container-full wpforms-render-modern\" id=\"wpforms-23333\"><form id=\"wpforms-form-23333\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"23333\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F23358\" data-token=\"68c954a3a0cac5be97b565c30bbfe1b0\" data-token-time=\"1775420601\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-hidden\" id=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/div><div class=\"wpforms-field-container\"><div id=\"wpforms-23333-field_1-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"1\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-23333-field_2-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"2\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_2\">Name: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-23333-field_2\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][2]\" aria-errormessage=\"wpforms-23333-field_2-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-23333-field_4-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"4\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_4\">Surname: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><input type=\"text\" id=\"wpforms-23333-field_4\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][4]\" aria-errormessage=\"wpforms-23333-field_4-error\" required><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-33\"><div id=\"wpforms-23333-field_3-container\" class=\"wpforms-field wpforms-field-date-time\" data-field-id=\"3\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_3\">Date: <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><div class=\"wpforms-datepicker-wrap\"><input type=\"text\" id=\"wpforms-23333-field_3\" class=\"wpforms-field-date-time-date wpforms-datepicker wpforms-field-required wpforms-field-medium\" data-date-format=\"F j, Y\" data-disable-past-dates=\"0\" data-input=\"true\" name=\"wpforms[fields][3][date]\" aria-errormessage=\"wpforms-23333-field_3-error\" required><a title=\"Clear Date\" data-clear class=\"wpforms-datepicker-clear\" style=\"display:none;\"><\/a><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-23333-field_5-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"5\"><div id=\"wpforms-23333-field_5\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-23333-field_5-error\"><p><strong>About:<\/strong> This scale is a self-report measure of anxiety. Items: 21<\/p>\n<p><strong>Reliability:<\/strong> Internal consistency for the BAI = (Cronbach\u2019s a=0.92)<br \/>\nTest-retest reliability (1 week) for the BAI = 0.75 (Beck, Epstein, Brown, &amp; Steer, 1988)<\/p>\n<p><strong>Validity:<\/strong> The BAI was moderately correlated with the revised Hamilton Anxiety Rating Scale (.51),<br \/>\nand mildly correlated with the Hamilton Depression Rating Scale (.25) (Beck et al., 1988).<\/p>\n<p><strong>Scoring:<\/strong><\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-23333-field_6-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"6\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_54-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"54\"><div id=\"wpforms-23333-field_54\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-23333-field_54-error\"><h4>0<\/h4>\n<p>Not at all<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_55-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"55\"><div id=\"wpforms-23333-field_55\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-23333-field_55-error\"><h4>1<\/h4>\n<p>Mildly, but it<br \/>\ndoesn\u2019t bother me much<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_56-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"56\"><div id=\"wpforms-23333-field_56\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-23333-field_56-error\"><h4>2<\/h4>\n<p>Moderately \u2013 it<br \/>\nisn\u2019t pleasant at<br \/>\ntimes<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_57-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"57\"><div id=\"wpforms-23333-field_57\" class=\"wpforms-field-medium wpforms-field-row\" aria-errormessage=\"wpforms-23333-field_57-error\"><h4>3<\/h4>\n<p>Severely \u2013 it<br \/>\nbothers me a lot<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-23333-field_58-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"58\"><div id=\"wpforms-23333-field_58\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-23333-field_58-error\"><p>The total score is calculated by adding the sum of the 21 items. Score of 0-21 = low anxiety<br \/>\nScore of 22-35 = moderate anxiety<br \/>\nScore of 36 and above = potentially concerning levels of anxiety<br \/>\nReferences: Beck, A.T., Epstein, N., Brown, G., &amp; Steer, R.A. (1988). An inventory for<br \/>\nmeasuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical<br \/>\nPsychology, 56, 893-897.<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><div id=\"wpforms-23333-field_59-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"59\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-100\"><div id=\"wpforms-23333-field_60-container\" class=\"wpforms-field wpforms-field-content\" data-field-id=\"60\"><div id=\"wpforms-23333-field_60\" class=\"wpforms-field-large wpforms-field-row\" aria-errormessage=\"wpforms-23333-field_60-error\"><p>Below is a list of common symptoms of anxiety. Please carefully read each item in the list. Indicate how much you have been bothered by that symptom during the past month, including today, by circling the number in the corresponding space in the column next to each symptom.<\/p>\n<div class=\"wpforms-field-content-display-frontend-clear\"><\/div><\/div><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-23333-field_28-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"28\"><div class=\"wpforms-field-layout-rows wpforms-field-large\"><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_61-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"61\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_61\">Numbness or Tingling <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_61\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][61]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_63-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"63\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_63\">Feeling Hot <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_63\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][63]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_64-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"64\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_64\">Wobbliness in legs <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_64\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][64]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_65-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"65\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_65\">Unable to relax <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_65\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][65]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_66-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"66\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_66\">Fear of worst happening <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_66\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][66]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_67-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"67\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_67\">Dizzy or lightheaded <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_67\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][67]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_68-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"68\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_68\">Heart pounding \/ Racing <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_68\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][68]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_69-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"69\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_69\">Unsteady <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_69\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][69]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_70-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"70\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_70\">Terrified or afraid <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_70\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][70]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_71-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"71\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_71\">Nervous <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_71\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][71]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_72-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"72\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_72\">Hands trembling <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_72\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][72]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_73-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"73\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_73\">Shaky \/ Unsteady <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_73\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][73]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_77-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"77\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_77\">Fear of losing control <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_77\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][77]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_76-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"76\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_76\">Difficulty in breathing <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_76\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][76]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_75-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"75\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_75\">Fear of dying <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_75\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][75]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_74-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"74\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_74\">Scared <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_74\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][74]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><\/div><div class=\"wpforms-layout-row\"><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_78-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"78\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_78\">Indigestion <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_78\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][78]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_79-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"79\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_79\">Faint \/ lightheaded <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_79\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][79]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_80-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"80\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_80\">Face flushed <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_80\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][80]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><div class=\"wpforms-layout-column wpforms-layout-column-25\"><div id=\"wpforms-23333-field_81-container\" class=\"wpforms-field wpforms-field-select wpforms-field-select-style-classic\" data-field-id=\"81\"><label class=\"wpforms-field-label\" for=\"wpforms-23333-field_81\">Hot \/ Cold sweats <span class=\"wpforms-required-label\" aria-hidden=\"true\">*<\/span><\/label><select id=\"wpforms-23333-field_81\" class=\"wpforms-field-medium wpforms-field-required\" name=\"wpforms[fields][81]\" required=\"required\"><option value=\"0. Not at all\" >0. Not at all<\/option><option value=\"1. Mildly, but it doesn\u2019t bother me much\" >1. Mildly, but it doesn\u2019t bother me much<\/option><option value=\"2. Moderately \u2013 it isn\u2019t pleasant at times\" >2. Moderately \u2013 it isn\u2019t pleasant at times<\/option><option value=\"3. Severely \u2013 it bothers me a lot\" >3. Severely \u2013 it bothers me a lot<\/option><\/select><\/div><\/div><\/div><\/div><\/div><div id=\"wpforms-23333-field_27-container\" class=\"wpforms-field wpforms-field-layout\" data-field-id=\"27\"><\/div><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"23333\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F23358\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-23333\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/versionx.bronwynrusso.com\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container --><\/div><\/div><\/div><\/div><\/div><\/div><\/div><!-- cell_inner --><\/div><!-- cell --><\/div><!-- port --><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":23278,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-23358","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=\/wp\/v2\/pages\/23358"}],"collection":[{"href":"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23358"}],"version-history":[{"count":1,"href":"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=\/wp\/v2\/pages\/23358\/revisions"}],"predecessor-version":[{"id":23360,"href":"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=\/wp\/v2\/pages\/23358\/revisions\/23360"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=\/wp\/v2\/media\/23278"}],"wp:attachment":[{"href":"https:\/\/versionx.bronwynrusso.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23358"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}