Questionnaire for identifying signs of vegetative changes according to A.M. Vein.. Take a free online course without registration.

14

Do you notice a tendency to blush when you are anxious?

Yes No

13

Do you notice a tendency for your face to pale when you are anxious?

Yes No

12

Do you experience numbness or coldness in your fingers or toes?

Yes No

11

Do you ever experience numbness or coldness in your hands or feet?

Yes No

10

Do you experience changes in the color of your fingers or toes (paleness, redness, blueness)?

Yes No

9

Do you experience any changes in the color of your entire hands or feet (pallor, redness, blueness)?

Yes No

8

Do you experience excessive sweating (constant or when anxious)?

Yes No

7

Do you often experience sensations of heart palpitations, "pauses," or "stoppages" of the heart?

Yes No

6

Do you often experience difficulty breathing (feeling of shortness of breath, rapid breathing)?

Yes No

5

Do you experience gastrointestinal dysfunctions (constipation, diarrhea, bloating, abdominal pain)?

Yes No

4

Do you ever experience fainting or feelings that you might lose consciousness?

Yes No

3

Do you experience episodic headaches?

Yes No

2

Do you notice a decrease in performance and quick fatigue?

Yes No

1

Do you notice any sleep disturbances?

Yes No