Mobility Inventory

Below, you can find a list of activities and situations which people with panic attacks are known to avoid. You should indicate to what extent you avoid these activities and/or situations that make you feel unpleasant or anxious. Indicate the degree of avoidance for when you are with someone you trust and for when you are alone.

Scoring:

1 = I never avoid it

2 = I rarely avoid it

3 = I avoid it sometimes

4 = I usually avoid it

5 = I always avoid it

For example, Jan always avoids lifts, but never when he is with his wife:

Lifts → together (1) – alone (5)

Below, you can find the list of situations and activities. You can skip the situations that do not apply to you.

 

Places

Theatres together __ alone ___

Supermarkets together __ alone ___

Shopping centre together __ alone ___

Classrooms together __ alone ___

Department stores together __ alone ___

Restaurant together __ alone ___

Museums together __ alone ___

Hitchhiking together __ alone ___

Theatre or stadiums together __ alone ___

Garages together __ alone ___

High places together __ alone ___

Enclosed spaces / tunnels together __ alone ___

 

Open spaces:

Outdoors (e.g. fields, wide roads, squares) together __ alone ___

Indoors (e.g. spacious rooms, large foyers) together __ alone ___

 

Transport:

Bus together __ alone ___

Train or tram together __ alone ___

Underground / metro together __ alone ___

Airplane together __ alone ___

Boat together __ alone ___

 

Driving a car:

On smaller roads together __ alone ___

On the highway together __ alone ___

 

Riding as a passenger in a car:

On smaller roads together __

On the highway together __

 

Other situations:

Queuing together __ alone ___

Crossing a bridge together __ alone ___

Attending parties together __ alone ___

Walking on the street together __ alone ___

Being home alone together __ alone ___

Being far from home together __ alone ___

 

Other:

…. together __ alone ___

…. together __ alone ___

…. together __ alone ___

…. together __ alone ___

 

Source: Keijsers, G. P. J., Van Minnen, A., Verbraak, M., Hoogduin, C. A. L. & Emmelkamp, P., (2017). Protocollaire behandelingen voor volwassenen met psychische klachten.