Agoraphobia Cognitions Questionnaire (ACQ)

Loss of Control items capture internal fears—fainting, collapsing, losing one's mind, or dying. Social Consequences items reflect external social judgment—people thinking you are crazy or weak. Treatment may emphasize interoceptive exposure and behavioral experiments for Loss of Control and social exposure and values-based work for Social Consequences.

Yes. Some individuals have catastrophic thoughts but do not avoid situations (e.g., anxious but courageous people). Conversely, others avoid without endorsing catastrophic cognitions (e.g., conditioned avoidance). ACQ measures cognition; behavioral assessment (e.g., avoidance patterns, functional impairment) is essential for diagnosis and treatment.

ACQ scores often decline within 4–8 weeks of cognitive restructuring and exposure therapy. Early drops (first 2–4 weeks) correlate with cognitive change; sustained reductions (8+ weeks) typically accompany avoidance reduction and panic symptom improvement.

The ACQ is less specific to social anxiety or GAD than to agoraphobia/panic. However, elevated ACQ scores can occur in any anxiety disorder with threat-focused thoughts. Always integrate ACQ results with disorder-specific measures (e.g., SPAI for social anxiety, PSWQ for GAD) for accurate case conceptualization.