Introduction
The Fear Questionnaire (FQ) is a brief self-rating scale that assesses the severity of phobic avoidance and measures change after treatment. Isaac Marks and Andrew Mathews published it in 1979 in Behaviour Research and Therapy. Its core 15 items cover agoraphobia, social phobia and blood-injury phobia, and the original study has received more than 2,440 citations.
The authors were based at the Institute of Psychiatry and the Maudsley Hospital, and at St. George's Hospital Medical School, London. This guide explains the FQ's items and subscales, how to score them, the evidence behind the scale and how to interpret its scores.
Key Features of the Fear Questionnaire (FQ)
Purpose and Use
The FQ assesses how severely people avoid phobic situations. In addition, clinicians and researchers use it to measure change after treatment.
Target Population
The FQ is generally used with adults (18+) with phobic disorders. It has been validated primarily in adult populations.
Structure
The full self-rating form has 24 items. At its core are 15 phobia items (items 2–16) about avoiding common situations, such as injections or minor surgery, eating with others, hospitals, travelling alone, crowded shops, public speaking and dental treatment. These form three five-item subscales:
Subscale
Items
Examples
Agoraphobia
5, 6, 8, 12, 15
Travelling alone, busy streets, crowded shops
Social Phobia
3, 7, 9, 11, 14
Eating with others, talking to authority, public speaking
Blood-Injury Phobia
2, 4, 10, 13, 16
Injections, hospitals, the sight of blood
The full form also includes:
A rating of the main phobia (item 1)An open question about other situations (item 17)Five anxiety-depression items (items 18–22): depressed mood, irritability or anger, tension or panic, intrusive upsetting thoughts, and feelings of unrealityAn open question about other feelings (item 23)A Global Phobia RatingScoring Method
Respondents rate each of the 15 phobia items from 0 to 8, according to how much they would avoid the situation because of fear or other unpleasant feelings. The complete form yields four principal measures:
Measure
How it is scored
Range
Main Target Phobia
One self-rated item
0–8
Global Phobia Rating
One separate global rating
0–8
Total Phobia
Sum of items 2–16
0–120
Anxiety-Depression
Sum of items 18–22
0–40
The agoraphobia, blood-injury and social phobia subscores each range from 0 to 40. Higher scores indicate greater phobic avoidance. The "other situations" and "other feelings" questions are scored separately.
Cut-off scores: the original study did not report a cut-off. However, a later validity study is cited for a Total Phobia score of 30 or more as a clinical threshold that can aid the identification of significant phobic disorders. Scores below 30 are often typical of non-clinical or sub-threshold fear.
Administration Format
The FQ is a self-administered rating form, so respondents complete it themselves using the 0–8 avoidance scale.
Applications of the Fear Questionnaire (FQ)
The FQ supports several clinical and research uses:
Treatment outcome: measuring change in phobic avoidance after treatment.Clinical assessment: profiling avoidance across agoraphobia, social phobia and blood-injury phobia.Research: rating phobic severity in studies of anxiety disorders.Languages and availability
Researchers have used and studied the FQ in several languages:
Chinese: a study using a Chinese versionSpanish: a comparison of English- and Spanish-language measuresFrench: a validation and factor analysis of the French versionGerman: the Angstfragebogen (AF), listed in the PSYNDEX test databaseNorwegian: a psychometric evaluation in a Norwegian sampleIsaac Marks holds the copyright. Permission has been granted for clinicians to reproduce the scale for use in their practice and for researchers to use it in non-industry studies. For any other use, contact the copyright owner.
Reliability and Validity
In the original study, the 15-item Total Phobia score showed good one-week test–retest reliability (0.82), and its three phobic subscores were also strongly reliable. The study supported the FQ's clinical sensitivity.
Validation studies:
Brief standard self-rating for phobic patients (1979): study linkValidity and clinical utility of the Fear Questionnaire for anxiety-disorder patients (1991): study linkThe Fear Questionnaire (1988): study linkThe fear questionnaire: a validity study (1986): study linkLimitations and Considerations
Keep these points in mind when using the FQ:
Self-report versus behavior: the authors noted that questionnaire data alone may not fully capture actual avoidance behavior.Adult validation: the FQ has been validated primarily in adult populations.Cut-off: the threshold of 30 comes from later research, not from the original study.Item count: some studies call only the 15 phobia items the FQ, while others use the full 24-item form, so state which version you use.Other Versions And Related Questionnaires
No other versions of the FQ are reported. In the original study, the term FQ referred to the 15 phobia items; later studies generally use it for the full questionnaire, including the FQ-Ag, FQ-Soc, FQ-BI and anxiety-depression subscales. In practice, most authors use the 15-item FQ.
These questionnaires are similar or complementary:
Fear Survey Schedule (FSS/FSS-III) and Wolpe-Lange Fear Survey SchedulePhobia Questionnaire (PHQ) and Gelder and Marks ScalesBeck Anxiety Inventory (BAI); see the ResRef BAI guideHospital Anxiety and Depression Scale (HADS); see the ResRef HADS guideSocial Phobia Scale (SPS), Social Interaction Anxiety Scale (SIAS) and Liebowitz Social Anxiety Scale (LSAS)Fear of Negative Evaluation Scale (FNE); see the ResRef BFNE guideKoala Fear Questionnaire (KFQ) for children, Pain Anxiety Symptoms Scale (PASS-20) and Surgical Fear Questionnaire (SFQ)Additional Resources
The original article: linkYou can access the FQ as a PDF through this linkFor inquiries, the original contact address is I. M. Marks, Institute of Psychiatry and the Maudsley Hospital, Denmark Hill, London; no verified email is available.Browse more anxiety questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Fear Questionnaire measure?The FQ measures how much people avoid phobic situations, across agoraphobia, social phobia and blood-injury phobia, and it tracks change after treatment. The full form also rates anxiety-depression symptoms.
How is the Fear Questionnaire scored?Each of the 15 phobia items is rated 0 to 8. Their sum gives a Total Phobia score of 0 to 120, and each five-item subscale ranges from 0 to 40. Higher scores mean more avoidance.
What is the cut-off score for the FQ?The original study reported none. A later validity study is cited for a Total Phobia score of 30 or more as a clinical threshold, while lower scores are often typical of non-clinical fear.
Is the Fear Questionnaire free to use?Clinicians may reproduce it for their practice and researchers may use it in non-industry studies. For other uses, contact the copyright owner, Isaac Marks.
A Word from ResRef About the Fear Questionnaire (FQ)
The Fear Questionnaire is a brief self-administered measure of phobic avoidance developed for clinical populations and treatment-outcome assessment. The 15-item Total Phobia score demonstrated good one-week test-retest reliability (0.82), with strong reliability for its three phobic subscores. The original study supports its clinical sensitivity, although the authors noted that questionnaire data alone may not fully capture actual avoidance behaviour.
References
Marks, I. M., & Mathews, A. M. (1979). Brief standard self-rating for phobic patients. Behaviour Research and Therapy, 17(3), 263–267. https://doi.org/10.1016/0005-7967(79)90041-xOei, T. P., Moylan, A., & Evans, L. (1991). Validity and clinical utility of the Fear Questionnaire for anxiety-disorder patients. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3(3), 391–397. https://doi.org/10.1037/1040-3590.3.3.391Cottraux, J., Bouvard, M., & Messy, P. (1987). [Validation and factor analysis of a phobia scale. The French version of the Marks-Mathews fear questionnaire]. L'Encephale, 13(1), 23–9. https://pubmed.ncbi.nlm.nih.gov/3582263/Van Zuuren, F. J. (1988). The Fear Questionnaire. British Journal of Psychiatry, 153(5), 659–662. https://doi.org/10.1192/bjp.153.5.659Novy, D. M., Stanley, M. A., Averill, P., & Daza, P. (2001). Psychometric comparability of English- and Spanish-language measures of anxiety and related affective symptoms. Psychological Assessment, 13(3), 347–55. https://doi.org/10.1037//1040-3590.13.3.347Johnsen, B. H., & Hugdahl, K. (1990). Fear questionnaires for simple phobias: psychometric evaluations of a Norwegian sample. Scandinavian Journal of Psychology, 31(1), 42–8. https://doi.org/10.1111/j.1467-9450.1990.tb00800.xMavissakalian, M. (1986). The fear questionnaire: a validity study. Behaviour Research and Therapy, 24(1), 83–85. https://doi.org/10.1016/0005-7967(86)90154-3