Form: Claustrophobia Questionnaire, CLQ

Claustrophobia Questionnaire, CLQ
1 – Extremely anxious
2 – Very anxious
3 – Moderately anxious
4 – Slightly anxious
5 – Not at all anxious
¹
1
2
3
4
5
1
Swimming while wearing a nose plug.
2
Working under a sink for 15 min.
3
Standing in an elevator on the ground floor with the doors closed.
4
Trying to catch your breath during vigorous exercise.
5
Having a bad cold and finding it difficult to breathe through your nose.
6
Snorkeling in a safe practice tank for 15 min.
7
Using an oxygen mask.
8
Lying on a bottom bunk bed.
9
Standing in the middle of the third row at a packed concert realizing that you will be unable to leave until the end.
10
In the centre of a full row at a cinema.
11
Working under a car for 15 min.
12
At the furthest point from an exit on a tour of an underground mine shaft.
13
Lying in a sauna for 15 min.
14
Waiting for 15 min in a plane on the ground with the door closed.
15
Locked in a small DARK room without windows for 15 min.
16
Locked in a small WELL-LIT room without windows for 15 min.
17
Handcuffed for 15 min.
18
Tied up with hands behind back for 15 min.
19
Caught in tight clothing and unable to remove it.
20
Standing for 15 min in a straitjacket.
21
Lying in a tight sleeping bag enclosing legs and arms, tied at the neck, unable to get out for 15 min.
22
Head first into a zipped up sleeping bag, able to leave whenever you wish.
23
Lying in the trunk of a car with air flowing through freely for 15 min.
24
Having your legs tied to an immovable chair.
25
In a public washroom and the lock jams.
26
In a crowded train which stops between stations.