Anxiety Control Questionnaire

The Anxiety Control Questionnaire (ACQ) is a validated self-report instrument designed to capture how much control an adult believes they have over their…

Questions: 30
Duration: 10 min
Original title: Anxiety Control Questionnaire
Adaptation: Anxiety Control Questionnaire
Authors: Rapee, R. M., Craske, M. G., Brown, T. A., & Barlow, D. H.
Created: 1996

The Anxiety Control Questionnaire (ACQ) is a validated self-report instrument designed to capture how much control an adult believes they have over their own emotional states and external environmental stressors. Perceived control is a central, transdiagnostic vulnerability factor in emotional disorders; individuals who feel they cannot influence threats or manage their physiological responses are often more susceptible to intense and prolonged distress.

In clinical practice, the ACQ offers a reliable, repeatable metric to assess this core cognitive dimension. Rather than merely cataloging symptoms, it directly measures the underlying sense of helplessness or mastery that drives avoidance and worry. By tracking these beliefs, clinicians can better understand the client's internal landscape and evaluate coping strategies intended to build resilience.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

75/ 150

The Anxiety Control Questionnaire (ACQ) is a 30-item self-report questionnaire that assesses an individual's perception of their ability to control external threatening events and internal anxiety-related emotional reactions. Low perceived control is considered a generalized psychological vulnerability factor involved in the development and maintenance of anxiety disorders and depression. Intended for adults, it enables screening, mechanism monitoring, and measurement of change in therapy (notably CBT).

0150

Scoring

Sum (reverse items recoded), total score and subscale scores, total score from 0 to 150, each item is scored on a 6-point scale (from 0 to 5).

Perceived control over external events/threats (Events)

36/ 80

"Events" subscale: perceived control over external events and threats ("perceived control over external events (Events)", Brown et al., 2004, describing the solution of Rapee et al., 1996).

items 1, 2, 5, 7, 8, 12, 14, 15, 16, 19, 20, 23, 24, 25, 29, 30

080

Perceived control over internal emotional reactions (Reactions)

39/ 70

"Reactions" subscale: perceived control over internal emotional reactions ("perceived control over internal reactions (Reactions)", Brown et al., 2004, describing the solution of Rapee et al., 1996).

items 3, 4, 6, 9, 10, 11, 13, 17, 18, 21, 22, 26, 27, 28

070

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What the test measures

The ACQ evaluates a person's generalized belief in their capacity to handle, influence, or tolerate anxiety-provoking situations and the physiological arousal that accompanies them. It breaks this overarching sense of control down into specific experiential domains.

Internal emotional reactions: The belief in one's capacity to modulate physiological arousal, stop a panic response, and manage intense feelings without being overwhelmed.
External threats: The perceived ability to navigate, escape, or positively influence challenging real-world situations, rather than feeling like a passive victim of circumstance.
Coping efficacy: The degree of confidence a person has in their own skills to handle unexpected adversity or stress, versus relying purely on chance or outside help.

This instrument is primarily designed for adults presenting with anxiety disorders or those looking to better understand their anxiety experience.

When and why to use it

Clinicians typically administer the ACQ when a patient's presentation is heavily colored by feelings of helplessness, unpredictability, or a rigid need to manage every outcome. It is a valuable tool at multiple stages of care.

Baseline formulation: To determine if a low sense of mastery is a primary driver of the patient's distress, helping to map their control-seeking habits early in treatment.
Treatment monitoring: To track changes in perceived control over the course of therapy, measuring whether skill-building genuinely translates to a stronger sense of capability.
Intervention planning: To identify whether therapy should focus more on addressing the intolerance of uncertainty or on building concrete skills for external stressors.
Evaluating coping shifts: To assess how effectively the patient transitions from avoidance toward active engagement, utilizing new coping strategies in difficult situations.

Using a validated score adds a structured, objective dimension to the clinical impression, allowing the practitioner to quantify subtle shifts in self-efficacy that might otherwise go unnoticed.

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The questions

Please read each statement carefully and indicate the extent to which it generally applies to you, using the scale from 0 (strongly disagree) to 5 (strongly agree). Answer as honestly as possible, thinking about how you usually feel rather than at any one particular moment.
1. I can usually avoid threats quite easily.
Assesses the patient's perceived self-efficacy in navigating away from potential external dangers.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
2. How I cope with difficult situations depends on whether or not outside help is available.
Probes the reliance on external support systems to manage adversity.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
3. When I'm put under stress, it's likely I'll lose control.
Evaluates the fear of decompensation or behavioral dysregulation under pressure.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
4. I can usually prevent my anxiety from showing.
Measures confidence in the ability to conceal outward signs of distress.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
5. When something scares me, there's usually nothing I can do.
Captures feelings of complete helplessness when confronted with fear-inducing stimuli.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
6. My emotions seem to have a life of their own.
Explores the subjective sense of emotional autonomy, where feelings feel disconnected from conscious modulation.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
7. There's little I can do to influence people's judgment of me.
Assesses perceived helplessness regarding interpersonal evaluation and social perception.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
8. Whether or not I successfully escape a frightening situation is always a matter of luck for me.
Probes external locus of control specifically regarding safety and escape.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
9. I often find myself shaking uncontrollably.
Evaluates the perceived inability to manage acute somatic symptoms of autonomic arousal.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
10. I can usually get worrying thoughts out of my mind easily.
Measures cognitive control over intrusive or ruminative worry.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
11. When I'm in a stressful situation, I'm able to stop myself from breathing too heavily.
Assesses the belief in one's capacity to regulate respiratory symptoms during stress.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
12. I can usually influence how much of a potential threat a situation is to me.
Captures the perceived ability to actively mitigate or reframe the severity of a threat.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
13. I am able to control my level of anxiety.
Probes the overall global belief in the capacity to modulate one's own anxious arousal.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
14. There is little I can do to change scary events.
Evaluates the sense of powerlessness in altering the course of frightening external events.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
15. How a difficult situation turns out has nothing to do with my actions.
Assesses a fatalistic view of outcomes, disconnecting personal agency from problem resolution.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
16. If something is going to hurt me, it will happen no matter what I do.
Explores catastrophic inevitability and the belief that defensive actions are futile.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
17. I can usually relax whenever I want to.
Measures confidence in the ability to intentionally initiate a state of physiological calm.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
18. When I'm under stress, I'm not always sure how I'm going to react.
Probes the fear of behavioral unpredictability when facing high demands.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
19. I can usually get people to like me if I put my mind to it.
Assesses social self-efficacy and the perceived ability to foster positive interpersonal connections.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
20. Most of the events that make me anxious are beyond my control.
Evaluates the broad perception that anxiety-provoking triggers belong to an uncontrollable external domain.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
21. I always know exactly how I will react in difficult situations.
Captures the individual's sense of behavioral certainty and self-knowledge in adversity.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
22. Getting anxious in a difficult situation doesn't worry me, because I'm confident in my ability to cope with my symptoms.
Measures meta-emotional tolerance and confidence in enduring autonomic symptoms without secondary distress.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
23. What people think of me is largely beyond my control.
Probes the perceived lack of agency over social reputation and external validation.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
24. I generally have a hard time dealing with difficult problems.
Assesses a generalized deficit in problem-solving confidence.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
25. When I hear that someone has a serious illness, I worry that I'll be next.
Evaluates the susceptibility to health anxiety and the personalization of external misfortunes.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
26. When I'm anxious, I find it hard to focus on anything other than my anxiety.
Captures attentional capture by anxiety and the inability to shift focus away from distress.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
27. I can cope with unexpected anxiety just as effectively as anxiety I anticipate.
Measures perceived resilience against sudden, unpredicted spikes in autonomic arousal.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
28. I sometimes think to myself, 'What's the point of trying to cope with my anxiety, since nothing I do seems to change how often or how intensely I feel it?'
Probes profound demoralization and the belief that all coping efforts are ultimately ineffective.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
29. I'm often able to get along well with 'difficult' people.
Assesses interpersonal efficacy specifically in challenging or conflict-prone social dynamics.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree
30. I avoid conflicts because of my inability to resolve them successfully.
Evaluates the use of behavioral avoidance driven by low conflict-resolution confidence.
- Strongly disagree
- Moderately disagree
- Slightly disagree
- Slightly agree
- Moderately agree
- Strongly agree