Cited by 349Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesCardiac Health and Mental HealthPsychosomatic Disorders and Their Treatments

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The Cardiac Anxiety Questionnaire: development and preliminary validity

Eifert, Georg H, Thompson, Risa N, Zvolensky, Michael J, Edwards, Kimberly, Frazer, Nicole L, Haddad, John W, Davig, James·2000·Behaviour Research and Therapy

DOI 10.1016/s0005-7967(99)00132-1

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Abstract

Heart-focused anxiety (HFA) is the fear of cardiac-related stimuli and sensations because of their perceived negative consequences. Although HFA is common to a wide variety of persons who experience chest pain and distress, it often is unrecognized and misdiagnosed, particularly in cardiology and emergency room patients without and with heart disease. To address these concerns, this article reports on the development and preliminary psychometric evaluation of the Cardiac Anxiety Questionnaire (CAQ) designed to measure HFA. In Study 1, 188 cardiology patients completed the CAQ. Item and factor analyses indicated a three-factor solution pertaining to heart-related fear, avoidance, and attention. Reliability analysis of the 18-item CAQ revealed good internal consistency of the total and subscale scores. In Study 2, 42 patients completed the CAQ and several other anxiety-related questionnaires to assess its convergent and divergent properties. Although preliminary validity results are promising, further psychometric study is necessary to cross-validate the CAQ, examine its test-retest reliability, and confirm the stability of the factor structure. Taken together, the CAQ appears to assess HFA, and may therefore be a useful instrument for identifying patients with elevated HFA without and with heart disease.

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Items 101–200 of 348

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“The most common form of measuring CA in a clinical setting has been to use the Cardiac Anxiety Questionnaire (CAQ) [4].”
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The Role of the Clinical Psychologist in the Care of Adults With Cardiovascular Disease
Smolderen, K. G. E., Gillaspy, S. R., Evers, A. W. M., Kovacs, A. H., Massa-Carroll, I., Moons, P., & Mena‐Hurtado, C. (2024) · JACC Advances · doi:10.1016/j.jacadv.2024.100910 · Cited by 25
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“The CAQ has demonstrated good reliability and validity [26].”
Background
Biomedical and Psychosocial Evaluation of "Cured" Adults with Congenital Heart Disease
Saidi, A. S., Paolillo, J., Fricker, F. J., Sears, S. F., & Kovacs, A. H. (2007) · Congenital Heart Disease · doi:10.1111/j.1747-0803.2007.00071.x · Cited by 20
Addressing PTSD in Implantable Cardioverter Defibrillator Patients: State-of-the-Art Management of ICD Shock and PTSD
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Cognitive-Behavior Therapy for Vietnamese Refugees With PTSD and Comorbid Panic Attacks
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Research in Review: Advancing Critical Care Practice
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Interdisciplinary and cross-sectoral perioperative care model in cardiac surgery: implementation in the setting of minimally invasive heart valve surgery (INCREASE)—study protocol for a randomized controlled trial
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“1STS One Minute Sit to Stand Test, 6MWT Six Minute Walk Test, BIPQ Brief Illness Perception Questionnaire, CAQ Cardiac Anxiety Questionnaire, EQ-5D-5L European Quality of Life 5 Dimensions 5 Level Version, FIMA Questionnaire for Health-Related Resource Use in an Elderly Population, GAD-2 Generalized Anxiety Disorder-2…”
Influential
Pre-surgery optimization of patients’ expectations to improve outcome in heart surgery: Study protocol of the randomized controlled multi-center PSY-HEART-II trial
Salzmann, S., Laferton, J. A. C., Mora, M. C. S., Horn, N., Gärtner, L., Schröder, L., Rau, J., Schade‐Brittinger, C., Murmann, K., Rastan, A. J., et al. (2022) · American Heart Journal · doi:10.1016/j.ahj.2022.07.008 · Cited by 20
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Psychometric Properties and Factor Structure of the Greek Version of the Cardiac Anxiety Questionnaire (CAQ)
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Anxiety and depression in inherited channelopathy patients with implantable cardioverter-defibrillators
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“The Cardiac Anxiety Questionnaire (CAQ) is an 18-item 5-point Likert scale survey divided into subscores for fear, avoidance, and heart-focused attention, which are reported from 0 to 4, with higher scores indicating worse anxiety.(14) The Florida Patient Acceptance Survey (FPAS) is an 18-item 5-point Likert scale sur…”
Background
Psychosocial assessment and psychological interventions following a cardiac event
Thompson, D. R., & Pedersen, S. S. (2023) · Heart · doi:10.1136/heartjnl-2022-321607 · Cited by 18
Physical activity and disability in patients with noncardiac chest pain: a longitudinal cohort study
Castonguay, J., Turcotte, S., Fleet, R. P., Archambault, P. M., Dionne, C. E., Denis, I., & Foldes‐Busque, G. (2020) · BioPsychoSocial Medicine · doi:10.1186/s13030-020-00185-9 · Cited by 19
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“Heart-focused anxiety will be assessed with the French version of the Cardiac Anxiety Questionnaire [102, 103].”
Method
Efficacy of 2 interventions for panic disorder in patients presenting to the ED with chest pain.
Pelland, M., Marchand, A., Lessard, M.-J., Belleville, G., Chauny, J., Vadeboncoeur, A., Poitras, J., Foldes-Busque, G., Bacon, S., & Lavoie, K. (2011) · American Journal of Emergency Medicine · doi:10.1016/j.ajem.2010.06.027 · Cited by 20
“With the exception of the CAQ, the pattern of results of AT analyses was similar to those observed with ITT analyses.”
MethodInfluential
Symptoms of Cardiac Anxiety in Family Members of Intensive Care Unit Patients.
Konstanti, Z., Gouva, M., Dragioti, E., Nakos, G., & Koulouras, V. (2016) · American Journal of Critical Care · doi:10.4037/ajcc2016642 · Cited by 16
Psychiatric disorders and cardiac anxiety in exercising and sedentary coronary artery disease patients: a case-control study
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“Because cardiac-related events are perceived to be aversive and dangerous, this behavior can promote anxiety that may elicit undesirable body symptoms (11).”
BackgroundMethod
Predictors of heart-focused anxiety in patients with stable heart failure.
Wedegärtner, S., Schwantke, I., Kindermann, I., & Karbach, J. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.06.065 · Cited by 13
Uncovering Phantom Shocks in Cardiac Patients with an Implantable Cardioverter Defibrillator
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The development and validation of the Worries About Recurrence or Progression Scale ( WARPS )
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Association of anxiety and recurrent cardiovascular events: investigating different aspects of anxiety
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“20,22 The subscales of the CAQ relate to a common way of categorizing anxiety based on phenomenological attributes.”
Background
Heart-related anxieties in relation to general anxiety and severity of illness in cardiology patients
Muschalla, B., Glatz, J., & Linden, M. (2014) · Psychology, Health & Medicine · doi:10.1080/13548506.2013.774428 · Cited by 17
“The Heart-Anxiety-Questionnaire (HAF) (Eifert et al., 2000; Hoyer & Eifert, 2004; Katz, Ford, Moskowitz, Jackson, & Jaffe, 1963) is a 17-item self-rating system that measures hypochondriac heart-related anxiety, anxious interpretation of symptoms, and avoidance behaviour.”
Background
Psychosocial care and cardiac genetic counseling following sudden cardiac death in the young
Ingles, J., & James, C. A. (2017) · Progress in Pediatric Cardiology · doi:10.1016/j.ppedcard.2017.03.001 · Cited by 16
The Effect of Internet-Delivered Cognitive Behavioral Therapy Versus Psychoeducation Only on Psychological Distress in Patients With Noncardiac Chest Pain: Randomized Controlled Trial
Mourad, G., Eriksson‐Liebon, M., Karlström, P., & Johansson, P. (2021) · Journal of Medical Internet Research · doi:10.2196/31674 · Cited by 13
“The total scale has demonstrated adequate reliability and validity XSL • FO RenderX [42].”
Background
The calibrated, unidimensional anxiety item bank for cardiovascular patients provided the basis for anxiety assessment in cardiovascular rehabilitation patients
Abberger, B., Haschke, A., Krense, C., Wirtz, M. A., Bengel, J., & Baumeister, H. (2013) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2012.08.009 · Cited by 14
Effect of guidance during cardiac catheterization on emotional, cognitive and behavioral outcomes
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A meta-analysis of the effects of mindfulness meditation training on self-reported interoception
Treves, I. N., Chen, Y., Wilson, C. L., Verdonk, C., Qinaʻau, J., Pustejovsky, J. E., Goldberg, S. B., Mehling, W. E., Schuman‐Olivier, Z., & Khalsa, S. S. (2025) · Scientific Reports · doi:10.1038/s41598-025-22661-4 · Cited by 21
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“The Cardiac Anxiety Questionnaire (CAQ) [53] has 18 items and a maximum score of 72 points, which measures the patient’s worry and anxiety, avoidance, and obsessive attention to their cardiac condition.”
Background
Brazilian Portuguese Validated Version of the Cardiac Anxiety Questionnaire
Sardinha, A., Nardi, A., de Araújo, C. G. D., Ferreira, M. C., & Eifert, G. (2013) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.20130207 · Cited by 11
Self-citation
Impact of organ transplantation in heart, lung and liver recipients: Assessment of positive life changes
Anand-Kumar, V., Kung, M., Painter, L., & Broadbent, E. (2014) · Psychology and Health · doi:10.1080/08870446.2014.882922 · Cited by 13
“Like the Cardiac Anxiety Questionnaire, researchers have the potential to use both total and subscale scores of the PETS (Eifert et al., 2000).”
Method
Reducing stress and anxiety in patients with myocardial infarction with non-obstructive coronary arteries or Takotsubo syndrome: A non-randomized feasibility study
Rondung, E., Humphries, S., Olsson, E. M. G., Sundelin, R., Norlund, F., Held, C., Spaak, J., Tornvall, P., & Lyngå, P. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100562 · Cited by 12
“…Cohen et al., 1983), severity of anxiety and depressive symptoms (HADS-A and HADS-D; Zigmond and Snaith, 1983), quality of life (Rand-36; Orwelius et al., 2018), symptoms of cardiac anxiety (CAQ; Eifert et al., 2000), and severity of posttraumatic stress symptoms (IES-6; Thoresen et al., 2010).”
Generalized anxiety is a predictor of impaired quality of life in patients with atrial fibrillation: Findings from the prospective observational ARENA study
Sadlonova, M., Salzmann, S., Senges, J., Celano, C. M., Huffman, J. C., Borggrefe, M. M., Akın, İ., Thomas, D., Schwarzbach, C. J., Kleemann, T., et al. (2023) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2023.111542 · Cited by 12
Associations of fear of physical activity, coping style and self-reported exercise behavior in patients with chronic heart failure
Spaderna, H., Brandenburg, V. M., Lauterbach, M., Partetzke, T. M., Schwab, S. U., Voss, F., & Kindermann, I. (2024) · PLoS ONE · doi:10.1371/journal.pone.0309952 · Cited by 15
“The German version of the Cardiac Anxiety Questionnaire [CAQ, 24], the Herzangstfrage-bogen [HAF-17, 35], was used to assess heart-focused fear, which is not unique to the presence of heart disease.”
BackgroundMethod
Cognitive behavioural therapy targeting cardiac anxiety post-myocardial infarction: results from two sequential pilot studies
Johnsson, A., Ljótsson, B., Liliequist, B. E., Skúladóttir, H., Maurex, L., Boberg, I., Ólafsdóttir, E., Klavebäck, S., Braunschweig, F., Mellbin, L., et al. (2025) · European Heart Journal Open · doi:10.1093/ehjopen/oeaf020 · Cited by 12
Psychokardiologische Rehabilitation – interdisziplinäre Behandlung als Pilotprojekt
Rademacher, W., Glatz, J., Langner, P., Köllner, V., & Langheim, E. (2018) · Der Kardiologe · doi:10.1007/s12181-018-0292-z · Cited by 12
Cognitive-behavioral rehabilitation in patients with cardiovascular diseases: a randomized controlled trial (CBR-CARDIO, DRKS00029295)
Bethge, M., Thome-Soós, F., Rašo, L. M., Weier, L., & Benninghoven, D. (2023) · BMC Cardiovascular Disorders · doi:10.1186/s12872-023-03272-1 · Cited by 7
“Cardiac anxiety is assessed with the German 17-item version of the Cardiac Anxiety Questionnaire.”
BackgroundMethodInfluential
Mental symptoms and quality of life in lipoprotein apheresis patients in comparison to hemodialysis patients, platelet donors and normal population.
Stasiewski, E., Christoph, M., Christoph, A., Bittner, A., Weidner, K., & Julius, U. (2015) · Atherosclerosis Supplements · doi:10.1016/j.atherosclerosissup.2015.02.035 · Cited by 11
“The Cardiac Anxiety Questionnaire (CAQ) is a 17-item self-report inventory score on a five-point Likert-type scale, anchored from 0 (never) to 4 (always) [15].”
Method
Quality of life and mental health of women who had cardiac disease in pregnancy and postpartum
Hutchens, J., Frawley, J., & Sullivan, E. A. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-05123-x · Cited by 11
“Cardiac anxiety questionnaire (CAQ) The CAQ was used as a specific assessment of cardiac anxiety, which is apprehension and fear related to cardiac-related stimuli and sensations [42].”
BackgroundMethodResult
Cognitive Functioning and Psychosocial Outcomes in Adults with Complex Congenital Heart Disease: A Cross-sectional Pilot Study
Verrall, C. E., Tran, D., Kasparian, N. A., Williams, T. A., Oxenham, V., Ayer, J. G., Celermajer, D. S., & Cordina, R. (2024) · Pediatric Cardiology · doi:10.1007/s00246-023-03376-7 · Cited by 11
“Cardiac Anxiety Questionnaire (CAQ) [39] includes 18 items that assessed cardiac-related anxiety.”
Background
Prevalência de transtornos psiquiátricos e ansiedade relacionada à saúde em coronariopatas participantes de um programa de exercício supervisionado
Sardinha, A., ARAUJO, C. G., Silva, A. C. D. O. E., & Nardi, A. (2011) · Archives of Clinical Psychiatry (São Paulo) · doi:10.1590/s0101-60832011000200004 · Cited by 13
The Physical Activity Levels and Sitting Time of Adults Living With Atrial Fibrillation: The CHAMPLAIN-AF Study
Way, K. L., Birnie, D. H., Blanchard, C., Wells, G., Dorian, P., Jorstad, H. T., Daha, I. C., Suskin, N., OH, P. I., Parkash, R., et al. (2022) · CJC Open · doi:10.1016/j.cjco.2022.01.004 · Cited by 10
“377 Daily activities score 76 (74e76) [568] 76 (74e81) [258] 76 (68e81) [84] 57 (31e81) [9] 69 (62e86) [41] 0.”
BackgroundInfluential
Heart-Focused Anxiety in Patients With Noncardiac Chest Pain
Israel, J., White, K. S., Farmer, C. C., Pardue, C. M., & Gervino, E. (2017) · Assessment (Odessa, Fla.) · doi:10.1177/1073191115597059 · Cited by 10
Patient-centered care in Coronary Heart Disease: what do you want to measure? A systematic review of reviews on patient-reported outcome measures
Pardo, Y., Garín, O., Oriol, C., Zamora, V., Ribera, A., & Ferrer, M. (2022) · Quality of Life Research · doi:10.1007/s11136-022-03260-6 · Cited by 16
Heart-Focused Anxiety Among Latinxs in Primary Care
Manning, K. F., Rogers, A. H., Bakhshaie, J., Viana, A. G., Lemaire, C. M., Garza, M. J., Ochoa‐Perez, M., & Zvolensky, M. J. (2019) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001020 · Cited by 11
Self-citation
Effectiveness of therapist-supported internet-based cognitive behavioural therapy interventions on depression, anxiety and quality of life among patients with cardiovascular disease: a systematic review and meta-analysis
Kwek, S. Q., Yeo, T. M., Teo, J. Y. C., Seah, A. C. W., Kai Ning, J. P., & Wang, W. (2025) · European Journal of Cardiovascular Nursing · doi:10.1093/eurjcn/zvaf084 · Cited by 13
The Influence of eHealth Stress Management Interventions on Psychological Health Parameters in Patients With Cardiovascular Disease: Systematic Review and Meta-Analysis
El-Malahi, O., Mohajeri, D., Bäuerle, A., Mincu, R. I., Rammos, C., Jansen, C., Teufel, M., Rassaf, T., & Lortz, J. (2025) · Journal of Medical Internet Research · doi:10.2196/67118 · Cited by 13
“A lower CAQ-total score in the intervention group reflecting a decrease in cardiac anxiety levels [34] was reported in 2 studies [24,25], while one study reported a lower CAQ-total score in the control group in comparison to the intervention group [27].”
Validation of the Valuing Questionnaire (VQ) in adults with cardiovascular disease and risk
Kibbey, M. M., DiBello, A. M., Babu, A. A., & Farris, S. G. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.07.006 · Cited by 11
The Trajectory of Nutritional Status and Physical Activity before and after Transcatheter Aortic Valve Implantation
van Erck, D., Dolman, C. D., Reimer, W. J. M. S. O., Henriques, J. P. S., Weijs, P. J. M., Delewi, R., & Schoufour, J. D. (2022) · Nutrients · doi:10.3390/nu14235137 · Cited by 11
“Anxiety was measured with the cardiac anxiety questionnaire (CAQ), which is a useful screening tool to determine heart-focused anxiety [32].”
Method
Inverse Correlation Between Cardiac Injury and Cardiac Anxiety
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“It is well validated in both psychiatric and cardiac populations.(12,13) A recent crossvalidation in the Netherlands(13) reported good internal consistency of both total (Cronbach’s ! = .”
Background
Do Cognitive and Behavioral Factors Mediate the Impact of Depression on Medical Outcomes in People With Coronary Heart Disease?
Dickens, C. M., Cherrington, A., & McGowan, L. (2011) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0b013e318207d32b · Cited by 10
Illness perception in overweight and obese patients with cardiovascular diseases
Pokrajac-Bulian, A., & Ambrosi-Randić, N. (2018) · Eating and Weight Disorders · doi:10.1007/s40519-018-0506-1 · Cited by 9
“The mean replacement method was used when 1 or 2 CAQ items were missing.”
BackgroundInfluential
Patient‐Reported Outcomes in a Multidisciplinary Electrophysiology‐Psychology Ventricular Arrhythmia Clinic
Sandhu, U. G., Nguyen, A. T., Dornblaser, J., Gray, A. R., Paladino, K., Henrikson, C. A., Kovacs, A. H., & Nazer, B. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.122.025301 · Cited by 10
Cardiac Anxiety in Patients Self-Referred for Electron Beam Tomography
Carmin, C. N., Wiegartz, P. S., Hoff, J. A., & Kondos, G. T. (2003) · Journal of Behavioral Medicine · doi:10.1023/a:1021747106450 · Cited by 10
“Using a large clinical sample (N D 1188), Eifert et al. (2000a) found that the CAQ is composed of three factors.”
BackgroundMethodInfluential
Gastrointestinal Diseases
Keefer, L., Taft, T., & Kiebles, J. L. (2012) · Wiley eBooks · doi:10.1002/9781118133880.hop209016 · Cited by 10
Heart-Focused Anxiety Is Prevalent in Adults With Congenital Heart Disease and Associated With Reduced Exercise Capacity
Willinger, L., Hock, J., Hager, A., Oberhoffer, R., Ewert, P., & Müller, J. (2022) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000763 · Cited by 9
Lessons from white coat hypertension: Comment on Spruill et al. “The impact of perceived hypertension status on anxiety and the white coat effect”
Leventhal, H., Contrada, R. J., & Leventhal, E. A. (2007) · Annals of Behavioral Medicine · doi:10.1007/bf02879916 · Cited by 9
“Eifert et al. ( 22 ) identified and assessed heart-focused anxiety, a fear of cardiac sensations due to their perceived, dangerous consequences, in patients with and without CAD.”
Background
Factors associated with pain level in non-cardiac chest pain patients with comorbid panic disorder
Foldes‐Busque, G., Hamel, S., Belleville, G., Fleet, R. P., Poitras, J., Chauny, J., Vadeboncœur, A., Lavoie, K., & Marchand, A. (2016) · BioPsychoSocial Medicine · doi:10.1186/s13030-016-0081-5 · Cited by 9
“*p < 0.05; ** p < 0.01 CAQ Cardiac Anxiety Questionnaire, PAS Panic and Agoraphobia Scale, ASI Anxiety Sensitivity Index, SF-MPQ-CP Short-form McGill Pain Questionnaire, chest pain version central factor implicated in NCCP reduction.”
MethodInfluential
Changes in cardiac anxiety and self-care practices in heart failure patients following implantation of wireless hemodynamic monitoring sensors
Sager, D. M., Burch, A. E., Alhosaini, H., Vaughan, T., & Sears, S. F. (2020) · European Journal of Cardiovascular Nursing · doi:10.1177/1474515120905405 · Cited by 9
Effectiveness of Internet-Based Cognitive Behavioral Therapy With Telephone Support for Noncardiac Chest Pain: Randomized Controlled Trial
Thesen, T., Himle, J. A., Martinsen, E. W., Walseth, L. T., Thorup, F., Gallefoss, F., & Jonsbu, E. (2021) · Journal of Medical Internet Research · doi:10.2196/33631 · Cited by 9
“The primary outcome measures were sum scores for the 18-item Cardiac Anxiety Questionnaire (CAQ), which measures worry or fear of heart sensations, avoidance of physical activity due to fear of eliciting heart symptoms, heart-focused attention, and reassurance seeking [11,12], and the 17-item Body Sensations Questionn…”
Background
Anxiety in children attending a specialist inherited cardiac arrhythmia clinic: a questionnaire study
Last, A. N., English, J., Pote, H. L., Shafran, R., Owen, T., & Kaski, J. P. (2018) · BMJ Paediatrics Open · doi:10.1136/bmjpo-2018-000271 · Cited by 9
“Asian or Asian British 6 (13) 6 (8) 0 (0)”
Randomised controlled trial protocol for the PROTECT-CS Study: PROTein to Enhance outComes of (pre)frail paTients undergoing Cardiac Surgery
Rose, A. V., Duhamel, T., Hyde, C., Kent, D., Afilalo, J., Schultz, A. S. H., Chudyk, A., Kehler, D., Dave, M. G., & Arora, R. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-037240 · Cited by 5
Implementierung einer Verhaltensmedizinisch Orientierten Rehabilitation in der Kardiologie
Benninghoven, D., Menke, E., China, C., Schroeder, F., & Bethge, M. (2022) · PPmP Psychotherapie Psychosomatik Medizinische Psychologie · doi:10.1055/a-1749-6379 · Cited by 8
The effects of internet-based cognitive behaviour therapy for depression in cardiovascular disease on symptoms of anxiety: a secondary analysis of a randomized trial.
Westas, M., Mourad, G., Andersson, G., Lundgren, J., & Johansson, P. (2024) · European Journal of Cardiovascular Nursing · doi:10.1093/eurjcn/zvad097 · Cited by 8
“…fear of cardiac-related stimuli and sensations because of their perceived negative consequences and can be seen as a cardiac-related fear disorder 8 and a risk factor for adverse outcomes in CVD. 9 Interestingly, in one study 9 using the Cardiac anxiety questionnaire (CAQ) to measure heart-focus…”
Method
Rapid Improvements in Physical Activity and Sedentary Behavior in Patients With Acute Myocardial Infarction Immediately Following Hospital Discharge
van Bakel, B. M. A., de Koning, I. A., Bakker, E. A., Pop, G., Cramer, G. E., van Geuns, R., Thijssen, D. H. J., & Eijsvogels, T. M. H. (2023) · Journal of the American Heart Association · doi:10.1161/jaha.122.028700 · Cited by 8
“22,23”
Examining the effectiveness of psychosocial interventions for patients with a cardiac implantable electronic device: A systematic review and meta-analysis
Nicmanis, M., Arcangeli, O., Chur‐Hansen, A., & Oxlad, M. (2025) · Heart Rhythm · doi:10.1016/j.hrthm.2025.02.027 · Cited by 9
Quality of life in sexagenarians after aortic biological vs mechanical valve replacement: a single-center study in China
Wang, L., Xu, N., Huang, S.-T., Chen, L., Cao, H., & Chen, Q. (2020) · Journal of Cardiothoracic Surgery · doi:10.1186/s13019-020-01143-w · Cited by 8
“The cardiac anxiety questionnaire (CAQ) is a scale developed by the Department of Psychology of West Virginia University to assess the severity of cardiovascular anxiety symptoms [9].”
Method
Family-authored ICU diaries to reduce fear in patients experiencing a cardiac arrest (FAID fear): A pilot randomized controlled trial
Cornelius, T. M., Mendieta, M., Cumella, R., Veneros, D. L., Tincher, I. M., Agarwal, S., & Kronish, I. M. (2023) · PLoS ONE · doi:10.1371/journal.pone.0288436 · Cited by 8
How is type D personality associated with the major psychological outcomes in noncardiac chest pain patients?
Roohafza, H., Bagherieh, S., Feizi, A., Khani, A., Yavari, N., Saneian, P., Teimouri-Jervekani, Z., & Sadeghi, M. (2021) · Personality and Mental Health · doi:10.1002/pmh.1527 · Cited by 7
The role of hypervigilance in chronic esophageal diseases: a scoping review
Guadagnoli, L. A., & Yadlapati, R. H. (2024) · Translational Gastroenterology and Hepatology · doi:10.21037/tgh-23-120 · Cited by 8
“However, studies are limited by their cross-sectional nature and inconsistent measurement tools (e.g., EHAS total, EHAS hypervigilance subscale, Cardiac Anxiety Questionnaire).”
Influential
Evaluation of the psychometric properties of the cardiac distress inventory in Iranian patients with heart disease
Nia, H. S., Marôco, J. P., Jackson, A. C., Salehi, S., Kaveh, O., Miraghai, F., & Hosseini, S. H. (2025) · Scientific Reports · doi:10.1038/s41598-025-02092-x · Cited by 7
Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction: A comprehensive review of clinical manifestations and interventions
Tang, X., Liu, G., & Zeng, Y.-J. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i12.110290 · Cited by 8
Initial assessment of the feasibility and efficacy of a scalable digital CBT for generalized anxiety and associated health behaviors in a cardiovascular disease population
Parsons, E. M., Hiserodt, M., & Otto, M. W. (2022) · Contemporary Clinical Trials · doi:10.1016/j.cct.2022.107018 · Cited by 7
Determinants of depression in non-cardiac chest pain patients: a cross sectional study
Roohafza, H., Yavari, N., Feizi, A., Khani, A., Saneian, P., Bagherieh, S., Sattar, F., & Sadeghi, M. (2021) · The Korean journal of pain · doi:10.3344/kjp.2021.34.4.417 · Cited by 7
“Heart-focused anxiety was defined as “the fear of cardiac-related stimuli and sensations because of their perceived negative consequences” [27].”
Background
Mindfulness-based intervention in patients with persistent pain in chest (MIPIC) of non-cardiac cause: a feasibility randomised control study
Mittal, T. K., Evans, E., Pottle, A., Lambropoulos, C., Morris, C., Surawy, C., Chuter, A., Cox, F., de Silva, R., Mason, M. J., et al. (2022) · Open Heart · doi:10.1136/openhrt-2022-001970 · Cited by 10
Cascade testing for inherited cardiac conditions: Risk perception and screening after a negative genetic test result
Fusco, K., Hylind, R. J., Cirino, A. L., Harris, S. L., Lubitz, S. A., Abrams, D. J., & Lakdawala, N. K. (2022) · Journal of Genetic Counseling · doi:10.1002/jgc4.1602 · Cited by 8
“The survey included novel questions developed by the research team, questions adapted from the literature, and questions from validated scales (Eifert et al., 2000; Esplen et al., 2015; Lipkus et al., 2000).”
BackgroundMethodInfluential
Disease-Specific Anxiety in Chronic Obstructive Pulmonary Disease: Translation and Initial Validation of a Questionnaire
Farver-Vestergaard, I., Rubio-Rask, S., Timm, S., Christiansen, C. F., Hilberg, O., & Løkke, A. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.907939 · Cited by 7
Aerobic training intervention in panic disorder: a case-series study
Gomes, R. M., Sardinha, A., de Araújo, C. G. S., Nardi, A. E., & Deslandes, A. C. (2014) · Medical Express · doi:10.5935/medicalexpress.2014.04.07 · Cited by 7
Psychological interventions for depression and anxiety in patients with coronary heart disease, heart failure or atrial fibrillation
Ski, C. F., Taylor, R. S., McGuigan, K., Lambert, J. D., Richards, S. H., & Thompson, D. R. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013508 · Cited by 7
Using behavioral experiments in the treatment of cardiophobia: A case study
Eifert, G. H., & Lau, A. W. (2001) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(01)80003-1 · Cited by 7
Self-citation
Randomized evaluation of routine beta-blocker therapy after myocardial infarction quality of life (RQoL): design and rationale of a multicentre, prospective, randomized, open, blinded endpoint study
Humphries, S., Mars, K., Hofmann, R., Held, C., & Olsson, E. (2023) · European Heart Journal Open · doi:10.1093/ehjopen/oead036 · Cited by 5
“(2) Heart-focused anxiety was measured by the 18-item Cardiac Anxiety Questionnaire (CAQ) 29 which ranks responses on a 0–4 scale of self-rated frequency of experiencing the behaviour.”
Influential
Psychological Interventions for Reducing Distress in Patients with Cardiac Arrhythmias
Särnholm, J., Gaffey, A. E., Turchioe, M. R., BIVIANO, A. B., & Burg, M. M. (2025) · Current Cardiology Reports · doi:10.1007/s11886-025-02253-4 · Cited by 7
“For example, arrhyth - mia-specific or cardiac-specific patient-reported outcome measures (e.g., the Cardiac Anxiety Questionnaire [ 71], Atrial Fibrillation Effect on Quality of Life Questionnaire [72 ], Florida Patient Acceptance Survey and Florida Shock Anxiety Scale [ 41, 73 ]), provide…”
Smidt Heart Institute Takotsubo Registry – Study design and baseline characteristics
Obrutu, O., Maughan, J., Tjoe, B., Herscovici, R., Moy, P., Rojas, N., Wei, J., SHUFELT, C. L., Rutledge, T. R., & Merz, C. N. B. (2022) · American Heart Journal Plus Cardiology Research and Practice · doi:10.1016/j.ahjo.2022.100086 · Cited by 6
“HFA is a fear of cardiac-related stimuli and sensations because of their perceived negative consequences while Trait-anxiety is a measure of individuals ’ relatively long-term susceptibility to anxiety [15,16].”
Background
The Canadian Women’s Heart Health Alliance ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women — Chapter 9: Summary of Current Status, Challenges, Opportunities, and Recommendations
Mulvagh, S. L., Colella, T. J. F., Gulati, M., Crosier, R., Allana, S., Randhawa, V. K., Bruneau, J., Pacheco, C., Jaffer, S., Cotie, L. M., et al. (2023) · CJC Open · doi:10.1016/j.cjco.2023.12.001 · Cited by 10
“…are available in a wide variety of languages and are easy and quick to use, with minimal patient, researcher, or clinician burden (eg, Patient Health Questionnaire-9, 150 Hospital Anxiety and Depression Scale, 151 Generalized Anxiety Disorder Assessment-7, 152 Cardiac Anxiety Questionnaire 153 ).”
Background
Protocol for the development and validation of a clinical measurement tool for fear of disease progression and recurrence in cardiac patients
Clarke, S. T., Grande, M. R. L., Murphy, B. M., Hester, R., & Jackson, A. C. (2024) · Chronic Diseases and Translational Medicine · doi:10.1002/cdt3.115 · Cited by 6
Monitoring Patients With Implantable Cardioverter Defibrillators Using Mobile Phone Electrocardiogram: Case Study
Kropp, C. M., Ellis, J. M., Nekkanti, R., & Sears, S. F. (2018) · JMIR Cardio · doi:10.2196/cardio.8710 · Cited by 6
“Patients were administered the Cardiac Anxiety Questionnaire (CAQ), which is an 18-item self-report measure designed to assess cardiac anxiety [10].”
BackgroundMethodInfluential
Heart-Focused Anxiety among Trauma-Exposed Latinx Young Adults: Relations to General Depression, Suicidality, Anxious Arousal, and Social Anxiety
Mayorga, N. A., Shepherd, J., Garey, L., Viana, A., & Zvolensky, M. J. (2021) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01054-z · Cited by 6
“The CAQ has shown good reliability [48] and excellent convergent and discriminant validity across a diverse range of populations [54, 67].”
BackgroundInfluentialSelf-citation
Heart-focused anxiety as a mediating variable in the treatment of non-cardiac chest pain by cognitive-behavioural and psychopharmacological treatment by paroxetine
Palsson, O. S. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2010.04.016 · Cited by 6
“, fear of cardiac-related stimuli and sensations because of their perceived negative consequences [14]).”
Background
Evaluation of Recurrent Takotsubo Syndrome
Marano, P., Maughan, J., Obrutu, O., Lauzon, M., Tjoe, B., Herscovici, R., Moy, P., Rojas, N., SHUFELT, C. L., Rutledge, T. R., et al. (2024) · JACC Advances · doi:10.1016/j.jacadv.2024.101247 · Cited by 5
PTSD and mood disorders in implantable cardioverter defibrillator patients: is more psychological assessment needed?
Sorrell, A., Harrell, R., Jordan, E., Sargeant, M. M., Nekkanti, R., Catanzaro, J. N., & Sears, S. F. (2024) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2024.2385974 · Cited by 5
“A high score indicates a greater number of symptoms, greater frequency, or both [13].”
Type of treatment of cardiac disorders – quality of life and heart-focused anxiety: The mediating role of illness perceptions
Panzaru, G. M., & Holman, A. C. (2014) · Psychology Health & Medicine · doi:10.1080/13548506.2014.989863 · Cited by 5
“Heart-focused anxiety was assessed with heart-focused anxiety questionnaire (Eifert et al., 2000) which consists of 18 items on three subscales (fear, avoidance, and attention).”
Method
Experience of internet‐delivered cognitive behavioural therapy among patients with non‐cardiac chest pain
Eriksson‐Liebon, M., Lundgren, J., Rytterström, P., Johansson, P., & Mourad, G. (2022) · Journal of Clinical Nursing · doi:10.1111/jocn.16565 · Cited by 5
Rationale and design of the NODE-303 study: evaluating the safety of symptom-prompted, self-administered etripamil for paroxysmal supraventricular tachycardia episodes in real-world settings
Ip, J. E., Bui, M., Camm, A. J., Coutu, B., Noseworthy, P. A., Parody, M. L., Sears, S. F., Singh, N., Agudelo-Uribe, J. F., Vyselaar, J. R., et al. (2024) · American Heart Journal · doi:10.1016/j.ahj.2024.01.007 · Cited by 5
Cognitive Behavioral Therapy for Paroxysmal Atrial Fibrillation
Skúladóttir, H., Särnholm, J., Ólafsdóttir, E., Arnardóttir, E. S., Hoppe, K., Bottai, M., Ljótsson, B., & Braunschweig, F. (2024) · JACC Advances · doi:10.1016/j.jacadv.2024.101289 · Cited by 5

Authors: Eifert, G. H., Thompson, R. N., Zvolensky, M. J., Edwards, K., Frazer, N. L., Haddad, J. W., & Davig, J.
Affiliations: West Virginia University (US)
Corresponding author: Eifert, Georg H
ORCID: Eifert, Georg H
Zvolensky, Michael J
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2000-10
Volume: 38
Issue: 10
Pages: 1039-1053
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/s0005-7967(99)00132-1
OpenAlex: W2015235226
Cited by: 349
References: 44
Citations by year: 2026: 24 · 2025: 28 · 2024: 25 · 2023: 23 · 2022: 43 · 2021: 23 · 2020: 27 · 2019: 12 · 2018: 15 · 2017: 9 · 2016: 15 · 2015: 12 · 2014: 10 · 2013: 11 · 2012: 12
FWCI: 4.33
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behaviour Research and Therapy (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords: psychometric development, questionnaire validation, avoidance, attention, chest pain, cardiac patients, anxiety assessment, factor structure

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The Cardiac Anxiety Questionnaire: development and preliminary validity

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