Table of Contents
Abstract
The Fear of Vomiting Questionnaire (FOV) is a specialized self-report questionnaire developed by David Veale to facilitate a thorough clinical assessment of emetophobia, formally classified as Specific Phobia of Vomiting (SPOV). This instrument is crucial for evaluating the multi-faceted nature of the phobia, encompassing the patient’s central cognitive distortions, the extent of employed safety and avoidance behaviours, and the resulting psychological and functional impairment. The structure of the FOV integrates elements adapted from established anxiety measures, particularly those assessing safety-seeking behaviors common in panic disorder. Clinically, the FOV serves as a diagnostic aid during initial intake and as a reliable outcome measure for assessing therapeutic efficacy post-treatment.
Keywords
Fear of Vomiting Questionnaire, FOV, Emetophobia, Specific Phobia of Vomiting (SPOV), Phobia Assessment, Avoidance Behavior, Safety Seeking Behavior, Cognitive Behavioral Therapy, Clinical Psychology, Psychological Assessment, Anxiety Disorders.
Authors
David Veale, C. Lambrou
Purpose
The fundamental purpose of the FOV is to provide clinicians with a detailed, multi-dimensional profile necessary for understanding patients afflicted by emetophobia. Unlike generic scales used for anxiety, the FOV specifically isolates and quantifies the unique manifestations of SPOV. It meticulously assesses core cognitive distortions, such as exaggerated beliefs regarding the probability and severity (awfulness) of a vomiting episode, alongside specific behavioral coping strategies employed, including both safety and avoidance measures.
Furthermore, the questionnaire captures essential historical context, such as the age of onset and formative past experiences related to vomiting or nausea. By providing a quantified measure of current severity and functional impairment across major life domains (social, occupational, relational), the FOV becomes an indispensable tool for customizing targeted interventions, particularly exposure-based treatments within Cognitive Behavioural Therapy (CBT).
Construct
The FOV is designed to measure the clinical construct of Emetophobia, or Specific Phobia of Vomiting (SPOV). This disorder is defined by an intense, overwhelming, and irrational fear centered on the act of vomiting—either personally or witnessing others vomit. The scale operationalizes the severity and complexity of this construct by dividing it into several measurable domains:
- Fear Specificity: Measures the distinction between the fear of self-vomiting (autophobia) and the fear of others vomiting (heterophobia).
- Cognitive Distortion: Evaluates catastrophic interpretations of ambiguous physical symptoms, such as nausea or digestive discomfort.
- Behavioral Avoidance: Quantifies the restriction of activities, environments (e.g., public transport, restaurants), foods, and necessary medical procedures due to the fear.
- Safety Behaviors and Rituals: Measures the frequency and intensity of protective actions, such as seeking reassurance, obsessive checking of food dates, excessive hand washing, or restrictive eating patterns, intended to prevent the perceived threat.
- Functional Impairment: Assesses the resulting negative impact of the phobia on the individual’s social relationships, employment, and overall quality of life.
This granular assessment allows clinicians to distinguish core phobic traits specific to SPOV from broader anxiety symptoms, thereby ensuring precise diagnostic profiling and effective intervention planning.
Validity
While the original source material does not report specific, formal psychometric studies detailing the internal factor structure, the FOV demonstrates strong content validity. Its design comprehensively maps onto the established symptomatic profile of emetophobia derived from extensive clinical observation and detailed case studies published in the psychological literature. The developers ensured consistency with recognized standards for anxiety assessment by incorporating and adapting items from existing, validated measures, particularly those assessing safety-seeking behaviors relevant to panic disorder.
Furthermore, the questionnaire has been consistently employed in published research surveys investigating the psychopathology of SPOV, supporting its ecological validity within clinical and research settings focused on this specific phobia.
Reliability
Specific indices of internal consistency, such as Cronbach’s alpha, and measures of test-retest reliability were not detailed in the source content for the FOV. However, the scale’s methodology suggests an inherent focus on reliable measurement. This is evidenced by the use of detailed, multi-point rating scales (e.g., 0-100% Likert scales) to quantify nuanced dimensions such as the occurrence of catastrophic thoughts, the strength of belief in those thoughts, and the perceived probability and awfulness of negative consequences (Q24, Q30). Reliability is therefore inferred from the instrument’s comprehensive and consistent application in clinical practice and research studies aimed at tracking the severity and treatment outcomes of SPOV.
Factor Analysis
Formal reports outlining an explicit factor analysis of the FOV were not included in the source documentation. Nevertheless, the instrument is structurally designed to capture multiple underlying dimensions critical to the manifestation of emetophobia. These implicit factors include Cognitive Distress (catastrophic thoughts and misappraisals of bodily sensations), Behavioral Restriction (the extent of avoidance behaviors related to food, travel, and social situations), and Safety Behaviors (rituals and checks). These dimensions are standard components utilized in the cognitive behavioral treatment models for specific phobias, suggesting that the FOV functions effectively as a multi-factorial clinical assessment tool.
Instrument
Test Type: Self-report questionnaire / Clinical Interview Aid
Format: Paper-and-pencil questionnaire consisting of 61 numbered items. Response formats include multiple choice, fill-in-the-blank questions, and various Likert-type scales (e.g., 0-8, 0-10, and 0-100% scales).
Language Available: English (Original)
Population Group: Clinical and non-clinical individuals experiencing a significant fear of vomiting.
Age Group: Primarily Adults. Items include questions related to life situations such as employment, marital status, and pregnancy, indicating suitability for adult populations.
Population Details: Specifically used to assess individuals formally diagnosed with or suspected of having Specific Phobia of Vomiting (SPOV).
Test Methodology: The scale systematically assesses several domains: historical data (onset, previous experiences), phenomenological experience (fear triggers, beliefs about nausea), cognitive appraisal (catastrophic thoughts), behavioral responses (safety behaviors and avoidance), and functional impairment across major life domains (social, occupational, and relational).
Keywords
Specific Phobia of Vomiting, David Veale, Self-report Inventory, Cognitive Distortions, Functional Impairment, Clinical Assessment, Avoidance Behaviors, Safety Seeking, Psychopathology.
Authors
Author ORCID Identifier: Not provided in source material.
Affiliation Email addresses: Not provided in source material.
Correspondence Address: Not provided in source material (Copyright D. Veale 2008).
Permissions & Fee and Test Year
The Fear of Vomiting Questionnaire (FOV) is copyrighted by David Veale (2008). Formal clinical or research utilization of the instrument requires users to seek explicit permission directly from the author or the affiliated institution. The scale was developed and published in conjunction with foundational research conducted in 2006. The original FOV PDF can be downloaded here: FOV. The follow-up version, designed for post-treatment assessment, is available here: FOV follow up.
Reference’s
The foundational research supporting the development and application of the FOV includes:
- Veale, D. and Lambrou, C. (2006). The psychopathology of vomit phobia. Behavioural and Cognitive Psychotherapy, 34 (2) 139-150.
- Copyright of D. Veale 2008.
Items of the Fear of Vomiting Questionnaire (FOV)
IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.
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How old were you?
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How distressing is the memory of the experiences on a scale of 0-10 (0 is not at all distressing and 10 is severe)?
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What were the circumstances or reasons for vomiting (e.g. infection‚ being drunk‚ pregnancy‚ travel sickness‚ food)?
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Did you experience any bad consequences from vomiting (e.g. reaction of a relative)? Does the episode carry other associations from that time (e.g. other bad
events happening in your life)? Do you have a sense that something bad happened (e.g. you nearly died)?
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How old were you?
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How distressing is the memory of the experience on a scale of 0-10 (0 is not at all distressing and 10 is severe)?
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What were the circumstances or reasons for you feeling nauseous?
Did you have a panic attack at the same time or severe anxiety which came on rapidly?
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Were there any bad consequences from feeling sick and panicky (e.g. reaction of a relative) or other associations at the time (e.g. other bad events happening in your life?) or a sense that something bad nearly happened because of this experience?
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How old were you?
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How distressing is the memory of the experience on a scale of 0-10 (0 is not at all distressing and 10 is severe)?
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What were the circumstances surrounding your past experience of vomit or of others vomiting?
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Were there any bad consequences of the other person vomiting (e.g. reaction of a relative) or other associations at the time (e.g. other bad events happening in your life?) or a sense that something bad nearly happened because of this experience?
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thoughts
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Occurrence
(Please rate 1-5)
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Belief
(Please rate 0-100)
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I am going to vomit
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I am going to pass out
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I will choke to death
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I am going to act foolishly
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I will lose control
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I will go crazy
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I am going to babble or talk strangely
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I will be paralysed with fear
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I am going to die
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I am seriously ill
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Other – please state
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Cause
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Rating 0-100%
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Anxiety
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Irritable Bowel Syndrome
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Migraine
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Balance Lean Problem??
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Cancer
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Ulcer or stomach inflammation
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Unknown physical cause
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Other (Please specify)_____________________
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Try to think about other things
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Never
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Sometimes
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Often
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Always
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Hold on to something tightly
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Never
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Sometimes
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Often
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Always
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Hold on to or lean on someone
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Never
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Sometimes
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Often
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Always
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Sit down
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Never
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Sometimes
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Often
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Always
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Keep still
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Never
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Sometimes
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Often
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Always
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Move very slowly
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Never
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Sometimes
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Often
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Always
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Look for an escape route
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Never
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Sometimes
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Often
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Always
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Make myself do more physical exercise
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Never
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Sometimes
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Often
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Always
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Focus attention on how I feel physically
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Never
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Sometimes
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Often
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Always
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Try to keep control of my mind
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Never
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Sometimes
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Often
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Always
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Try to keep tight control over my vomiting
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Never
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Sometimes
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Often
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Always
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Talk more
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Never
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Sometimes
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Often
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Always
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Ask people around for help
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Never
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Sometimes
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Often
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Always
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Change my breathing
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Never
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Sometimes
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Often
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Always
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Physically check my body
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Never
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Sometimes
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Often
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Always
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Eat something
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Never
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Sometimes
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Often
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Always
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Go to bed
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Never
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Sometimes
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Often
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Always
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Suck on ice
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Never
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Sometimes
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Often
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Always
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Read
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Never
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Sometimes
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Often
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Always
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Suck antacids/mints
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Never
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Sometimes
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Often
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Always
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Recite a phrase
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Never
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Sometimes
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Often
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Always
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Reassure myself no-one will vomit (inc me)
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Never
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Sometimes
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Often
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Always
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Seek reassurance from others
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Never
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Sometimes
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Often
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Always
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Take medication
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Never
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Sometimes
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Often
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Always
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1______________________________
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Never
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Sometimes
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Often
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Always
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2______________________________
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Never
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Sometimes
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Often
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Always
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3______________________________
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Never
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Sometimes
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Often
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Always
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4______________________________
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Never
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Sometimes
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Often
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Always
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Consequences
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Probability of event
occurring
(0-100: See scale above)
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Awfulness if event
occurred
(0-100: See scale above)
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I will lose control
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I will choke
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I will become very ill
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I will die
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I will faint
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I will carry on vomiting for ages
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Others will not want to know me
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Others will find me repulsive
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Other (specify): __________________
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Other (specify):__________________
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a) Have you ever been pregnant?
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Yes
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No
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b) If yes‚ how many times?
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Yes
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No
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c) If yes‚ did you feel sick during any pregnancy?
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Yes
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No
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d) If yes‚ did you vomit during any pregnancy or childbirth?
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Yes
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No
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e) Are you avoiding having children because of a fear of vomiting?
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Yes
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No
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f) Have you ever terminated a pregnancy because of a fear of vomiting?
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Yes
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No
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Foods avoided
(please specify in
spaces below)
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How much
you avoid if
you prepare
or cook the
food
(0-100%)
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How much you
avoid if someone
else prepares or
cooks the food
(e.g. in a restaurant)
(0-100%)
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Please describe why
you avoid this food
(e.g. fat content or spiciness of the food‚
previous experience of vomiting )
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Time of day
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What do you typically eat?
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How much do you
restrict what you eat?
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Activity/Place/ Object
avoided because of a
fear of vomiting
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How much
you avoid
(0-100%)
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Please describe and give details about what you
avoid or specific measures you use if you can’t
avoid it
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Public Toilets
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Eating at Restaurants
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Eating from salad bars or buffets
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Eating food that you have
not prepared yourself
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Speaking in Public
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Sitting Exams
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Holidays Abroad
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Visiting the Dentist
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Attending an Interview
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Visiting your GP
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Illegal Drugs
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Alcohol
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Crowded Places
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Places where I can’t cook for myself
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Drunks
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Pubs
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Activity/Place/ Object
avoided because of a fear of
vomiting
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How much
you avoid
(0-100%)
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Please describe and give details about what you
avoid or specific measures you use if you do can’t
avoid it
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Public Transportation (buses‚ trains‚ etc.)
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Sea travel by boat
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Travel by aero plane
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Driving a car
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Being a passenger in a car
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Visiting others who are ill in
hospital
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Receiving treatment in hospital
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Adults who are ill or might vomit
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Children or babies who areill or might vomit
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Certain Films or television programs
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Fairground Rides
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Places that smell of vomit
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Certain words relating to vomiting (please give details)
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If yes‚ what words do you use?
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Foreign holidays (even if the travel was possible)
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Other
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Cite this article
Mohammed looti (2025). Fear of Vomiting Questionnaire (FOV). Psychological Scales & Instruments Database. Retrieved from https://db.arabpsychology.com/scales/fear-of-vomiting-questionnaire-fov/
Mohammed looti. "Fear of Vomiting Questionnaire (FOV)." Psychological Scales & Instruments Database, 2 Nov. 2025, https://db.arabpsychology.com/scales/fear-of-vomiting-questionnaire-fov/.
Mohammed looti. "Fear of Vomiting Questionnaire (FOV)." Psychological Scales & Instruments Database, 2025. https://db.arabpsychology.com/scales/fear-of-vomiting-questionnaire-fov/.
Mohammed looti (2025) 'Fear of Vomiting Questionnaire (FOV)', Psychological Scales & Instruments Database. Available at: https://db.arabpsychology.com/scales/fear-of-vomiting-questionnaire-fov/.
[1] Mohammed looti, "Fear of Vomiting Questionnaire (FOV)," Psychological Scales & Instruments Database, vol. X, no. Y, ص Z-Z, November, 2025.
Mohammed looti. Fear of Vomiting Questionnaire (FOV). Psychological Scales & Instruments Database. 2025;vol(issue):pages.