Hello

I am Aditya Anil, a Psychology undergraduate at Amity University, Noida. I am conducting research

on ‘Social anxiety and its effect on wellbeing’.

I request you to kindly fill out this form if you lie within the age range 18-30 years. It will take
approximately 5-10 minutes to fill this form and your participation would be highly appreciated.
There are no right or wrong answers, so please choose whatever seems right to you. The
information provided by you would be kept confidential and will be used only for research
purposes.

Thank you!

Informed Consent: in order to participate in the study, it is necessary to give your consent. By agreeing
this statement, you are indicating that you understand the nature of the study and your role in this
research and are willing to participate in this research. The result of this study will be used for fulfil the
requirement of a research project for a degree of bachelors in psychology. I invite you to be a
prospective participant of this research as a study is focusing on sample of working people in India
within the age group of 18-25 years. By taking this box you are solely giving your consent.

Agree

Name:
Age:
Sex:

LSAS-SR
Read each situation carefully and answer two questions about it; the first question asks how anxious or
fearful you feel in the situation; the second question asks how often you avoid it. If you come across a
situation that you ordinarily do not experience, we ask that you imagine “what if you were faced with
that situation”, and then rate the degree to which you would fear this hypothetical situation and how
often you would tend to avoid it (using the 0 to 3 scales below). Please base your ratings on the way
that situations have affected you in the last week (or other agreed time period).
fear or none mild moderate severe
anxiety
0 1 2 3
avoidance never (0%) occasionally (1-33%) often (33-67%) usually (67-100%)

anxiety avoidance
1 telephoning in public (p)
2 participating in small groups (p)
3 eating in public places (p)
4 drinking with others in public places (p)
5 talking to people in authority (s)
acting, performing or giving
6 a talk in front of an audience (p)
 7 going to a party (s)
8 working while being observed (p)
9 writing while being observed (p)
10 calling someone you don’t know very well (s)
11 talking with people you don’t know very well (s)
12 meeting strangers (s)
13 urinating in a public bathroom (p)
14 entering a room when others are already seated (p)
15 being the center of attention (s)
16 speaking up at a meeting (p)
17 taking a test (p)
expressing a disagreement or
18
disapproval to people you don’t know
very well (s)
19 looking at people you don’t very well in the eyes (s)
20 giving a report to a group (p)
21 trying to pick up someone (p)
22 returning goods to a store (s)
23 giving a party (s)
24 resisting a high-pressure salesperson (s)
total performance (p) sub score
total social interaction (s) sub score
total score

WHO-5 WBI

Please respond to each item by marking one box per row, regarding how you feel.

Most More Less Some

All of At no
of than than Of
the time
the half the half the the
time
time time time time
1 I have felt cheerful in good spirits.
5 4 3 2 1 0
2 I have felt calm and relaxed. 5 4 3 2 1 0
3 I have felt active and vigorous.
5 4 3 2 1 0
4 I woke up feeling fresh and rested. 5 4 3 2 1 0
My daily life has been filled with
5 things that interest me. 5 4 3 2 1 0