Worry and Anxiety Questionnaire (WAQ)

Abstract

The Worry and Anxiety Questionnaire (WAQ) is a specialized, efficient self-report instrument developed to quantitatively assess the severity and functional impact of pathological worry and its accompanying somatic symptoms. Originally conceptualized and validated by Dugas and colleagues in 2001, the WAQ (11 items) and its subsequent refinement, the WAQ-II (8 items, refined by Amelie Doucet in 2008), are fundamentally grounded in the cognitive model of Generalized Anxiety Disorder (GAD).

This scale is designed to capture the core diagnostic features of GAD, specifically focusing on the perceived excessiveness of worries, the difficulty in controlling the worry process (known as uncontrollability), and the degree to which these chronic symptoms lead to functional impairment in daily life. The WAQ is critical for researchers investigating cognitive mechanisms, particularly the role of Intolerance of Uncertainty, and serves as an important clinical tool for both initial screening and monitoring the efficacy of therapeutic interventions.

Keywords

Worry, Anxiety, Generalized Anxiety Disorder, GAD, Pathological Worry, Self-Report, Psychometrics, Intolerance of Uncertainty, Cognitive Behavioral Treatment, WAQ, Psychological Scale, Somatic Symptoms.

Authors

Michel J. Dugas, Marc H. Freeston, Roxane Ladouceur, Amelie Doucet, Chantal Doucet, Sonia Lachance, Martin Provencher, P. Gosselin.

Purpose

The primary objective of the Worry and Anxiety Questionnaire (WAQ) is to offer a comprehensive, yet time-efficient, measure that maps directly onto the core diagnostic criteria for Generalized Anxiety Disorder (GAD). Unlike simpler measures that only gauge the frequency of worrisome thoughts, the WAQ uniquely quantifies the subjective experience of symptom severity, chronicity over the past six months, and the resulting functional impairment.

In clinical practice, the WAQ is invaluable for initial diagnostic screening and, crucially, for tracking patient progress during psychological treatment. It is particularly sensitive to changes resulting from interventions based on Cognitive Behavioral Treatment (CBT), as these protocols often target the cognitive mechanisms assessed by the scale, such as the perceived uncontrollability of worry. By requiring respondents to consider symptoms over a six-month window, the WAQ effectively captures the persistent, chronic nature characteristic of pathological worry.

Construct

The WAQ is designed to measure the multidimensional construct of Pathological Worry, which is defined as a persistent chain of negative, upsetting thoughts regarding potential future threats to oneself or others. This construct is operationalized across several key components that are essential for distinguishing clinical GAD from normative worry:

• Excessiveness and Pervasiveness: This dimension assesses the degree to which the individual perceives their worrying as disproportionate, exaggerated, or “blown out of proportion” relative to actual circumstances.
• Uncontrollability: This is a core feature in the GAD cognitive model, measuring the perceived difficulty or inability to stop, manage, or interrupt the worrying process once it has begun.
• Somatic Symptoms: The scale includes items capturing the physical manifestations associated with chronic anxiety, such as fatigue, restlessness, muscle tension, concentration deficits, irritability, and sleep disturbance.
• Functional Impairment: This component quantifies the extent to which the cognitive and somatic symptoms of worry interfere with major life domains, including occupational performance, social engagement, and family responsibilities.

Validity

The validity of the WAQ has been robustly established through rigorous psychometric studies involving comparisons between nonclinical and clinical populations, confirming its precision in measuring GAD-specific characteristics. The scale demonstrates excellent convergent validity, exhibiting strong correlations with other widely accepted measures of chronic worry, notably the Penn State Worry Questionnaire (PSWQ).

Furthermore, validation research confirms the WAQ’s strong discriminant validity. This indicates that the instrument successfully differentiates individuals diagnosed with GAD from those presenting with other types of anxiety disorders (e.g., specific phobias or panic disorder). This specificity underscores its utility in precisely capturing the core features of generalized pathological worry, consistent with Dugas’s cognitive model which highlights the central role of Intolerance of Uncertainty in GAD etiology.

Reliability

Both the original WAQ and the revised WAQ-II demonstrate strong psychometric reliability, particularly regarding internal consistency. This high consistency ensures that all items within the scale reliably cohere to measure the underlying construct of overall pathological worry severity. While specific Cronbach’s alpha coefficients may vary across different research samples, they are consistently reported at high levels, affirming the strong homogeneity of the instrument’s items.

The scale also exhibits acceptable test-retest reliability over short intervals (typically 2 to 4 weeks). This stability is crucial for chronic symptom measures, confirming that the instrument consistently assesses stable traits of pathological worry in stable populations. Consequently, the WAQ is highly suitable for use in research designs requiring pre- and post-treatment symptom comparisons.

Factor Analysis

Although the WAQ is primarily utilized to generate a single, dimensional total score reflective of overall worry severity and functional impairment, factor analytic studies often reveal a structure that aligns with the distinct components of GAD symptoms. Typically, the items cluster into two related but separable factors: the cognitive aspects of worry (e.g., uncontrollability and excessiveness) and the physiological/somatic manifestations of chronic anxiety (e.g., muscle tension and restlessness).

The subsequent revision, the WAQ-II, was specifically designed to be an even more focused and parsimonious instrument. In this refined version, item scores are combined to provide a clear, quantitative assessment that aligns closely with the modern diagnostic criteria outlined in the DSM for Generalized Anxiety Disorder.

Instrument

Test Type: Self-Report Questionnaire / Psychological Assessment Scale

Format: The original WAQ comprises 11 items, typically utilizing a 5-point Likert rating scale (ranging from 1 to 5). The revised WAQ-II contains 8 items and uses a refined 5-point rating scale (0, 2, 4, 6, 8) designed to potentially enhance sensitivity, often supplemented by initial open-ended questions regarding common worry themes.

Language Available: English, French.

Population Group: Clinical samples (specifically patients diagnosed with GAD) and nonclinical university/community samples.

Age Group: Adolescents and Adults.

Population Details: The scale is particularly vital in academic and clinical research focused on the cognitive model and treatment efficacy for GAD. This includes contexts testing the effectiveness of cognitive restructuring and exposure-based CBT protocols.

Test Methodology: Respondents are asked to rate the frequency, subjective severity, and resulting functional impact of excessive worry and associated somatic symptoms experienced over the preceding six months.

Keywords

Psychological assessment, WAQ-II, M.J. Dugas, GAD symptoms, Somatic complaints, Uncontrollability, Pathological worry, Cognitive model, Diagnostic tool.

Authors

Author ORCID Identifier: N/A (Information not provided in source.)

Affiliation Email addresses: N/A (Information not provided in source.)

Correspondence Address: N/A (Information not provided in source.)

Permissions & Fee and Test Year

The initial validation data for the original WAQ was published in 2001 (Dugas et al.). The subsequent, refined version, the WAQ-II, was formally documented in 2008 by Amelie Doucet. The instrument is commonly employed in academic research affiliated with the authors’ institutions, such as Université Laval and Concordia University. For non-commercial academic use, the scale is generally accessible via the comprehensive publications referenced below.

The original PDF instruments for the WAQ can be downloaded here:

• http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.633.2700&rep=rep1&type=pdf
• http://www.collectionscanada.gc.ca/obj/s4/f2/dsk3/ftp04/MQ64017.pdf

Reference’s

• Dugas, M. J., Freeston, M. H., Doucet, C., Lachance, S., & Ladouceur, R. (1995). Structured versus free-recall measures: Effects on report of worry themes. Personality and Individual Differences, 18, 355-362.
• Dugas, M. J., Freeston, M.H., & Ladouceur, R. (1997). Intolerance of uncertainty and problem orientation in worry. Cognitive Therapy and Research, 21, 593- 606.
• Dugas, M. I., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour Research and Therapy, 36, 215-226.
• Ladouceur, R., Dugas, M. I., Freeston, M. H., Léger, Eliane, Gagnon, Fabien, & Thibodeau, Nicole. (1998). Efficacy of a Cognitive—Behavioral Treatment for Generalized Anxiety Disorder Evaluation in a Controlled Clinical Trial.
• Dugas, M. J., Freeston, M. H., Provencher, M., Lachance, S., Ladouceur, R., & Gosselin. (2001). The Worry and Anxiety Questionnaire: Validation in nonclinical and clinical samples. Journal de Thérapie de Comportemetale et Cognitive, 11, 31-36.
• Dugas, M. J., Gosselin, P., & Ladouceur, R. (2001). Intolerance of uncertainty and worry: investigating narrow specificity in a nonclinical sample. Cognitive Therapy and Research, 25, 551-558.

Items of the Worry and Anxiety Questionnaire (WAQ)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. What subjects do you worry about most often?

a) __________________, b) _______________, c) ________________

d) __________________, e) _______________, e) ________________

For the following items, please circle the corresponding number (1 to 5).

2. Do your worries seem excessive or exaggerated?

1- Not at all excessive, 3- Moderately excessive, 5 – Totally excessive

3. Over the past six months, how many days have you been bothered by excessive worry?

1- Never, 3- day out of2, 5- Everyday

4. Do yon have difficulty controlling your worries? For example, when you start worrying about something, do you have difficulty stopping?

1- No difficulty, 3- Moderate difficulty, 5- Extreme difficulty

5. Over the past six months, to what extent have you been disturbed by the following sensations when you were worried or anxious? Rate each sensation by circling a number (1 to 5).

a) Restlessness or feeling keyed up or on edge

1- Not at all, 3- Moderately, 5- very severely

b) Being easily fatigued

1- Not at all, 3- Moderately, 5- very severely

C) Difficulty concentrating or mind going blank

1- Not at all, 3- Moderately, 5- very severely

d) Irritability

1- Not at all, 3- Moderately, 5- very severely

e) Muscle tension

1- Not at all, 3- Moderately, 5- very severely

f) Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep). 1- Not at all, 3- Moderately, 5- very severely

6. To what extent does worry or anxiety interfere with your life? For example, your work, social activities, family life, etc.?

1- Not at all, 3- Moderately, 5- very severely