The Anxiety Control Questionnaire (ACQ)

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Self-Report Measures, Screenings and Assessments

The Anxiety Control Questionnaire (ACQ)

THC Editorial Team January 24, 2022
Lake George, 1869, John Frederick Kensett, The Metropolitan Museum of Art (article on Anxiety Control Questionnaire/ACQ)
Lake George, 1869, John Frederick Kensett, The Metropolitan Museum of Art


What Is the Anxiety Control Questionnaire?

The Anxiety Control Questionnaire (ACQ) is a self-administered tool commonly used by clinicians to measure perceived control, which research has shown predicts the severity of anxiety symptoms and the outcomes of cognitive behavioral therapy. It is a quick, cost-effective way to indicate whether someone may need to seek professional help for issues related to anxiety or anxiety-provoking situations.

Research has consistently shown that people who believe they have limited control in potentially negative situations are at increased risk for anxiety-related stress and emotional disorders.1 However, because individuals can hypothetically improve their perceived control over anxiety-inducing situations through cognitive behavioral therapy, they may be able to reduce the severity of their anxiety and depression symptoms. This questionnaire is an excellent tool to help professionals distinguish anxiety disorders within clinical and nonclinical populations.2

What Does the Anxiety Control Questionnaire Measure?

This 30-item questionnaire assesses an individual’s perceived ability to control anxiety-inducing situations. Researchers have found that when people feel lower levels of control in uncertain situations, they tend to feel higher levels of anxiety and depression, and lower subjective quality of life.3,4 This questionnaire helps professionals predict the severity of a person’s symptoms and how well patients will incorporate their therapy lessons and apply them in real-life settings.3

Scoring Guidelines

Scoring on the ACQ is straightforward. Respondents answer each item with a number on a six-point Likert scale that ranges from 0 to 5.5

0 – Strongly disagree

1 – Moderately disagree

2 – Slightly disagree

3 – Slightly agree

4 – Moderately agree

5 – Strongly agree

Perceived control is calculated by totaling all of the item scores. Higher scores are indicative of greater perceived control. In addition to a total score, results from the ACQ provide two subscale scores: control over internal reactions and control over external events.6

Validity and Reliability

In a study on the validity of the ACQ and its reliability in assessing perceived control among psychiatric inpatients, Lang and McNiel found that lower levels of perceived control were significantly associated with higher levels of both anxiety and depression, lower levels of perceived quality of life, and higher levels of perceived negative pressure.6

In another study evaluating the validity and reliability of the ACQ in a group of 1,550 psychiatric outpatients diagnosed with mood and anxiety disorders and 360 nonclinical participants, researchers found that this measure had good inter-item reliability, test-retest reliability, internal consistency, discriminant validity, and convergent validity.1


Although there has been little empirical work on this questionnaire, some researchers have found that if individuals perceive they have little control over anxiety-inducing situations, they are more likely to express maladaptive beliefs or analyze stimuli inaccurately.7 More research would be helpful to explore the utility of this measure further.


  1. Brown, T. A., White, K. S., Forsyth, J. P., & Barlow, D. H. (2004). The structure of perceived emotional control: Psychometric properties of a revised anxiety control questionnaire. Behavior Therapy, 35(1), 75–99.
  2. Osma, J., Barrada, J. R., García-Palacios, A., Navarro-Haro, M., & Aguilar, A. (2016). Internal structure and clinical utility of the Anxiety Control Questionnaire-Revised (ACQ-R) Spanish Version. Spanish Journal of Psychology, 19, E63.
  3. Gallagher, M. W., Bentley, K. H., & Barlow, D. H. (2014.) Perceived control and vulnerability to anxiety disorders: A meta-analytic review. Cognitive Therapy and Research, 38, 571–584.
  4. Lang, A. J., & McNiel, D. E. (2006). Use of the Anxiety Control Questionnaire in psychiatric inpatients. Depression and Anxiety, 23(2), 107–112.
  5. University of Wisconsin–Madison, Addiction Research Center. (2020). Anxiety Control Questionnaire (ACQ). Retrieved December 15, 2020, from
  6. Gerolimatos, L. A., Gould, C. E., & Edelstein, B. A. (2012). Exploratory factor analysis of the Anxiety Control Questionnaire among older adults. Behavior Modification, 36(4), 600–616.
  7. Gregor, K. L., & Zvolensky, M. J. (2008). Anxiety sensitivity and perceived control over anxiety-related events: evaluating the singular and interactive effects in the prediction of anxious and fearful responding to bodily sensations. Behaviour research and therapy, 46(9), 1017–1025.

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