Social-emotional assessment tool PDF
Summary
Use the panic disorder severity scale (PDSS) to accurately measure seven key clinical domains, including attack frequency, distress levels, and the impact of symptoms on social and work life.
Evaluate patient progress by tracking PDSS scores over time to determine the effectiveness of current treatment plans and interventions.
Identify specific phobic avoidance behaviors and physical triggers using the structured 0–4 rating system.
Download the provided digital checklist to integrate standardized symptom tracking directly into your electronic health records for better clinical documentation.
This article covers everything clinicians need to know about the panic disorder severity scale (PDSS), including the full questionnaire, severity ratings, and diagnostic criteria for panic disorder.
We’ve also included a free downloadable panic symptoms checklist to save to your electronic health record (EHR) and use in your practice.
What is the panic disorder severity scale?
The panic disorder severity scale (PDSS) is a clinician-administered measure that assesses the severity of panic symptoms. This article presents the self-report version (PDSS-SR), which is suitable for use as a client-facing intake form or digital checklist. It is validated for use with adults. Clinicians should use judgment when administering it with adolescents under 18.
The measure assesses the following key areas related to panic disorder:
Frequency of panic attacks
Level of distress during panic attacks
Anticipatory anxiety about future attacks
Avoiding places or situations in fear of panic attacks, such as being in a crowded space or on public transportation
Phobic avoidance of physical sensations
The impact of symptoms on social functioning, work, home, and responsibilities
Below is the specific panic disorder questionnaire in the PDSS and its severity ratings.
Question 1: How many panic and limited symptom attacks did you have during the week?
0 — No panic or limited symptom episodes
1 — Mild: No full panic attacks and no more than one limited symptom attack/day
2 — Moderate: One or two full panic attacks and/or multiple limited symptom attacks/day
3 — Severe: More than two full attacks but not more than one per day on average
4 — Extreme: Full panic attacks occurred more than once a day, more days than not
Question 2: If you had any panic attacks during the past week, how distressing (uncomfortable, frightening) were they while they were happening?
0 — Not at all distressing, or no panic or limited symptom attacks during the past week
1 — Mildly distressing (not too intense)
2 — Moderately distressing (intense, but still manageable)
3 — Severely distressing (very intense)
4 — Extremely distressing (extreme distress during all attacks)
Question 3: During the past week, how much have you worried or felt anxious about when your next panic attack would occur or about fears related to the attacks?
0 — Not at all
1 — Occasionally or only mildly
2 — Frequently or moderately
3 — Very often or to a very disturbing degree
4 — Nearly constantly and to a disabling extent
Question 4: During the past week, were there any places or situations you avoided, or felt afraid of, because of fear of having a panic attack?
0 — Not at all
1 — Occasionally or only mildly
2 — Frequently or moderately
3 — Very often or to a very disturbing degree
4 — Nearly constantly and to a disabling extent
Question 5: During the past week, were there any activities that you avoided, or felt afraid of, because they caused physical sensations like those you feel during panic attacks or that you were afraid might trigger a panic attack?
0 — No fear or avoidance of situations or activities because of distressing physical sensations
1 — Mild: Occasional fear and/or avoidance, but usually I could confront or endure with little distress activities that cause physical sensations. There was little modification of my lifestyle due to this
2 — Moderate: Noticeable avoidance but still manageable. There was definite, but limited, modification of my lifestyle such that my overall functioning was not impaired
3 — Severe: Extensive avoidance. There was substantial modification of my lifestyle or interference in my functioning
4 — Extreme: Pervasive and disabling avoidance. There was extensive modification in my lifestyle due to this such that important tasks or activities were not performed
Question 6: During the past week, how much did the above symptoms altogether interfere with your ability to work or carry out your responsibilities at school, or home?
0 — No interference with work or home responsibilities
1 — Slight interference with work or home responsibilities, but I could do nearly everything I could if I didn't have these problems
2 — Significant interference with work or home responsibilities, but I still could manage to do the things I needed to do
3 — Substantial impairment in work or home responsibilities; there were many important things I couldn't do because of these problems
4 — Extreme, incapacitating impairment such that I was essentially unable to manage any work or home responsibilities
Question 7: During the past week, how much did panic and limited symptom attacks or worry about attacks interfere with your social life?
0 — No interference
1 — Slight interference with social activities, but I could do nearly everything I could if I didn't have these problems
2 — Significant interference with social activities, but I could manage to do most things if I made the effort
3 — Substantial impairment in social activities; there are many social things I couldn't do because of these problems
4 — Extreme, incapacitating impairment, such that there was hardly anything social I could do
Interpreting PDSS scores
Total scores range from 0 to 28. Use the following ranges to guide interpretation:
0–3: Normal / Remission
4–5: Borderline
6–9: Slightly ill (mild panic disorder)
10–16: Moderately ill
17–21: Markedly ill
22–28: Severely ill
Clinicians should interpret scores alongside clinical interview findings rather than in isolation.
Panic disorder assessment criteria
If you are diagnosing a client with panic disorder (code F41.0), the ICD-10 diagnostic criteria include:
Recurrent, unexpected panic attacks and persistent worry about having additional panic attacks.
At least one month of persistent worry about future attacks or significant behavioral changes following an attack.
Panic attacks start with intense apprehension, fear, or terror and, often, a feeling of impending doom.
Psychological and physical/autonomic symptoms include:
Dyspnea or sensations of being smothered
Dizziness
Loss of balance or faintness
Intense fear
Feelings of terror
Chest pain
Breathing difficulties
Choking sensations
Palpitations or accelerated heart rate
Shakiness
Sweating
Nausea or other form of abdominal distress
Depersonalization or derealization
Paresthesias
Hot flashes or chills
Chest discomfort or pain
Fear of dying and fear of not being in control of oneself or “going crazy”
Note: US clinicians typically diagnose using DSM-5-TR criteria while billing under the ICD-10 code F41.0.
How to use the panic symptoms checklist
You can download and use our panic attack checklist in several ways:
Print or screen share the panic disorder severity scale as a psychoeducational prompt in client sessions.
Use the PDSS as part of intake paperwork.
Go through the checklist as a session check-in to measure progress.
Give the PDSS worksheet to other providers or supervisees who may find it helpful.
Sources
Furukawa, T. A., Katherine Shear, M., Barlow, D. H., Gorman, J. M., Woods, S. W., et al. (2009). Evidence-based guidelines for interpretation of the Panic Disorder Severity Scale. Depression and anxiety.
Houck, P. R., Spiegel, D. A., Shear, M. K., & Rucci, P. (2002). Reliability of the self-report version of the Panic Disorder Severity Scale. Depression and Anxiety.
Keough, M. E., Porter, E., Kredlow, M. A., Worthington, J. J., Hoge, E. A., et al. (2012). Anchoring the Panic Disorder Severity Scale. Assessment.
Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., et al. (1997). Multicenter Collaborative Panic Disorder Severity Scale. American Journal of Psychiatry.
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. World Health Organization.
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