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Pain Anxiety Symptom Scale Short Form 20
                                                                     
                                                                                       Never                                          Always

1	 I can’t think straight when in pain	0	1	2	3	4	5	
2	 During painful episodes it is difficult for me to
think of anything besides the pain	0	1	2	3	4	5	
3	 When I hurt I think about pain constantly	0	1	2	3	4	5	
4	I find it hard to concentrate when I hurt	0	1	2	3	4	5	
5	 I worry when I am in pain	0	1	2	3	4	5	
6	I go immediately to bed when I feel severe pain	0	1	2	3	4	5	
7	 I will stop any activity as soon as I sense
pain coming on	0	1	2	3	4	5	
8	As soon as pain comes on I take
medication to reduce it	0	1	2	3	4	5	
9	 I avoid important activities when I hurt	0	1	2	3	4	5	
10	I try to avoid activities that cause pain	0	1	2	3	4	5	
11	 I think that if my pain gets too severe it
will never decrease	0	1	2	3	4	5	
12	When I feel pain I am afraid that something
terrible will happen	0	1	2	3	4	5	
13	When I feel pain I think I might be seriously ill	0	1	2	3	4	5	
14	Pain sensations are terrifying	0	1	2	3	4	5	
15	When pain comes on strong I think that I might
become paralyzed or more disabled	0	1	2	3	4	5	
16	I begin trembling when engaged in activity that
increases pain	0	1	2	3	4	5	
17	Pain seems to cause my heart to pound or race	0	1	2	3	4	5	
18	 When I sense pain I feel dizzy or faint	0	1	2	3	4	5	
19	 Pain makes me nauseous	0	1	2	3	4	5	
20	I find it difficult to calm my body down
after periods of pain	0	1	2	3	4	5	

McCracken LM, Dhingra L. A short version of the Pain Anxiety Symptoms Scale (PASS-20): preliminary development and validity. Pain Res Manag. 2002;7(1):45-50.