PLEASE COMPLETE IN BLACK INK ONLY.
Self-Assessment of Resilience and
Anxiety Scale (SARA)
8665
initials
ID #
married
age
gender
marital status
/
date
separated
never married
male
female race or ethnic origin
widowed
divorced
refused
/
visit
protocol number
white, not Hispanic origin
black, not Hispanic origin
Asian
Native American or Alaskan native
other
Hispanic
unsure
Indicate how accurately each of the following statements describes you as you
have been during the last week:
1 My body feels relaxed.
not at all
0
a little bit
1
2
somewhat
3
4
3
4
3
4
3
4
3
4
3
4
5
very much
6
7
6
7
6
7
6
7
6
7
6
7
6
7
8
extremely
9
10
2 I feel calm.
not at all
0
a little bit
1
2
somewhat
5
very much
8
extremely
9
10
3 My thoughts are focused.
not at all
0
a little bit
1
2
somewhat
5
very much
8
extremely
9
10
4 I feel confident.
not at all
0
a little bit
1
2
somewhat
5
very much
8
extremely
9
10
5 I am free of worries.
not at all
0
a little bit
1
2
somewhat
5
very much
8
extremely
9
10
6 I feel sociable.
not at all
0
a little bit
1
2
somewhat
5
very much
8
extremely
9
10
7 I do not avoid things because of fear.
not at all
0
a little bit
1
2
somewhat
3
4
5
very much
8
extremely
9
10
8 I can bounce back after a stress or disappointment.
not at all
0
a little bit
1
2
somewhat
3
4
5
very much
6
7
8
extremely
9
Copyright Jonathan R. T. Davidson and Kathryn M. Connor (1998)
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7/9/02
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