Fear of Vomiting Questionnaire (FOV) is a report devised by David Veale which is used for clinicians to provide a comprehensive of the beliefs‚ safety and avoidance behaviours‚ degree of handicap associated with SPOV caused and avoidance behaviours adopted. Some of the items are adapted from standard questionnaires (e.g. of safety seeking behaviours in ). Some of the items may be used after treatment to assess . The was used in the published surveys of SPOV.

Download the FOV and the FOV follow up

Veale‚ D. and Lambrou‚ C. (2006). The of vomit phobia. Behavioural and Cognitive Psychotherapy‚34 (2) 139-150

Fear of Vomiting Questionnaire

Name: ___________________________ Date: ___________________________

Please complete this questionnaire as best as you can to help us understand as much as possible about your fear.

1) How old were you when you first became aware of your of ? _______

2) How old were you when your of became a significant problem? ____

3) Since your of became a problem‚ what course has it taken? Please circle the letter next to the statement that best describes your problem.

a) It has been continuous but overall the problem has become worse

b) It has been continuous but overall the problem has stayed much the same

c) It has been continuous but overall the problem has got better

d) It has varied. Although it has never gone away‚ there have been times when the problem has been much worse and times when it has been much better

e) It has varied. At times it has not been a problem at all and at other times it has been worse

4) How old were you when you first sought help for your of ? ________

5) How old are you now? _____________

6) For how many years have you NOT vomited? _____________

7) Sex: (Please circle) Female / Male

8) Marital Status: (Please circle) Single / Married or co-habiting / Divorced / Widowed

9) Employment Status: (Please circle) Unemployed / Long-Term Sick Leave / Student Employed or Employed / Homemaker / Other ____________

10) Please read all the options below and circle the letter that best describes your current situation

a) I only myself (not others)

b) My main is of myself but I have some of others

c) I equally myself and others

d) My main is of others but I have some of myself

e) I only others (not myself)

11) If you others ‚ please circle one or more reasons for this .

Please go to question 12 if you only yourself and not others.

a) I may catch something from the person and then vomit myself

b) It makes me think I could vomit one day

c) It reminds me of past experiences of

d) Another ( Please specify) ____________________________

12) Please read all the options below and circle the letter attached to the statement that best describes your of whether you are in public or alone

a) I myself in public or social situations only

b) My main is of myself in public but I have some of alone

c) I myself whether it is in public/social situations or alone

d) My main is alone but I also have some of in public or social situations

e) I myself only when I am alone

13) Have you ever had any experiences of in your life? Yes No

If yes‚ please list your past experience(s) of yourself (not retching) from the earliest age you can remember up to the present day. Please use an additional sheet if you need the space.

How old were you?	How distressing is the memory of the experiences on a scale of 0-10 (0 is not at all distressing and 10 is severe)?	What were the circumstances or reasons for vomiting (e.g. infection‚ being drunk‚ pregnancy‚ travel sickness‚ food)?	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)?

14) Have you ever had any experience of feeling nauseous or retching (but not ) and feeling panicky in your life? Yes No

If yes‚ please list your past experience(s) of feeling nauseous/retching from the earliest age you can remember up to the present day. Please use an additional sheet if you need the space.

How old were you?	How distressing is the memory of the experience on a scale of 0-10 (0 is not at all distressing and 10 is severe)?	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?	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?

15) Have you had any bad experiences of vomit or of other people in front of you or on you? Yes No

If yes‚ please list your past experience(s) of vomit or of others from the earliest age you can remember. Please use an additional sheet if you need the space.

How old were you?	How distressing is the memory of the experience on a scale of 0-10 (0 is not at all distressing and 10 is severe)?	What were the circumstances surrounding your past experience of vomit or of others vomiting?	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?

16) How often‚ on average‚ do you think a woman vomits from an infection or food-poisoning in your country?

Once every _______month(s) OR ________ year(s)

17) How often in the future do you think you will vomit from an infection or food-poisoning?

Once every _________ month(s) OR _________ year(s)

18) How long on average‚ do you think an of from an infection or food-poisoning would last for in an average woman?

_________ Minutes OR _________ hours OR _________ days

19) If you were to suffer an of caused by infection or food-poisoning how long do you think it would last for?

_________ Minutes OR _________ hours OR _________ days

20) What proportion of women do you think vomit during their first pregnancy?

________%

21) What proportion of women do you think vomit during the second or third pregnancy?

________%

22) What proportion of women do you think vomit after a general an aesthetic?

________%

23) What proportion of women do you think vomit during foreign travel in a third world or emerging country (e.g. India)?

________%

24) What goes through your when you feel nauseous?

a. Please indicate how often you experience each of the thoughts in the following list: rate each thought from 1 to 5 using the scale below; put your rating in the column marked ‘OCCURENCE’.

1-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-2-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-3-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-4-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-‎-5

1= Thought never occurs 2= Thought rarely occurs 3=Thought occurs during half of the times when I feel nauseous 4 = Thought usually occurs 5= Thought always occurs when I feel nauseous

b. When you feel sick‚ how much do you believe each of the thoughts below to be true? Please rate each thought from 0 to 100 using the scale below; put your rating in the ‘BELIEF’ column.

0-‎-‎-‎-‎-‎-‎-‎-‎-10-‎-‎-‎-‎-‎-‎-‎-‎-20-‎-‎-‎-‎-‎-‎-‎-‎-30-‎-‎-‎-‎-‎-‎-‎-‎-40-‎-‎-‎-‎-‎-‎-‎-‎-50-‎-‎-‎-‎-‎-‎-‎-‎-60-‎-‎-‎-‎-‎-‎-‎-‎-70-‎-‎-‎-‎-‎-‎-‎-‎-80-‎-‎-‎-‎-‎-‎-‎-‎-90-‎-‎-‎-‎-‎-‎-‎-‎-100

0=I do not believe this Thought at all‚ 20= I am slightly convinced this thought is true‚ 50= I am half convinced this thought is true‚ 70= I am very convinced this thought is true‚ 100= I am completely convinced this thought is true

thoughts	Occurrence (Please rate 1-5)	Belief (Please rate 0-100)
I am going to vomit
I am going to pass out
I will choke to death
I am going to act foolishly
I will lose control
I will go crazy
I am going to babble or talk strangely
I will be paralysed with fear
I am going to die
I am seriously ill
Other – please state

25) If you thought you might “lose control“‚ can you describe what you think will happen‚ from the of what others would see and from your own of what you would feel?

…………………………………………………………………………………………

26) How many days a week over the past week have you felt nauseous [at least some of the time]?

________ Days during the past week

27) What do you believe is the of your nausea?

Please rate the strength of your for each of these causes on a scale between 0 -100% where 0% is not at all convinced and 100% is totally convinced.

Cause	Rating 0-100%
Anxiety
Irritable Bowel Syndrome
Migraine
Balance Lean Problem??
Cancer
Ulcer or stomach inflammation
Unknown physical cause
Other (Please specify)_____________________

28) Do you do any of the following when you feel sick? Please circle one for each item.

Try to think about other things	Never	Sometimes	Often	Always
Hold on to something tightly	Never	Sometimes	Often	Always
Hold on to or lean on someone	Never	Sometimes	Often	Always
Sit down	Never	Sometimes	Often	Always
Keep still	Never	Sometimes	Often	Always
Move very slowly	Never	Sometimes	Often	Always
Look for an escape route	Never	Sometimes	Often	Always
Make myself do more physical exercise	Never	Sometimes	Often	Always
Focus attention on how I feel physically	Never	Sometimes	Often	Always
Try to keep control of my mind	Never	Sometimes	Often	Always
Try to keep tight control over my vomiting	Never	Sometimes	Often	Always
Talk more	Never	Sometimes	Often	Always
Ask people around for help	Never	Sometimes	Often	Always
Change my breathing	Never	Sometimes	Often	Always
Physically check my body	Never	Sometimes	Often	Always
Eat something	Never	Sometimes	Often	Always
Go to bed	Never	Sometimes	Often	Always
Suck on ice	Never	Sometimes	Often	Always
Read	Never	Sometimes	Often	Always
Suck antacids/mints	Never	Sometimes	Often	Always
Recite a phrase	Never	Sometimes	Often	Always
Reassure myself no-one will vomit (inc me)	Never	Sometimes	Often	Always
Seek reassurance from others	Never	Sometimes	Often	Always
Take medication	Never	Sometimes	Often	Always

What kind of do you currently take‚ how often do you take it and at what dose?

_________________________________________________________________________________

29) What else do you do if you think you are going to vomit? (Please circle)

1______________________________	Never	Sometimes	Often	Always
2______________________________	Never	Sometimes	Often	Always
3______________________________	Never	Sometimes	Often	Always
4______________________________	Never	Sometimes	Often	Always

30) Please read through the list of consequences that you think might occur after in the first of the table.

a) In the second column please rate the likelihood of the consequence occurring if you were to vomit‚ on a scale between 0 and 100 using the scale below as a guide.

0= Impossible‚ 25= Unlikely‚ 50= Possible‚ 75= Likely‚ 100= Certain

b) In the third column rate how awful the consequence would be if it occurred on a scale between 0 and 100 using the second scale below.

0=Not at all bad‚ 25= Rather bad‚ 50= Bad‚ 75= Really awful‚ 100= The most awful thing possible

Consequences	Probability of event occurring (0-100: See scale above)	Awfulness if event occurred (0-100: See scale above)
I will lose control
I will choke
I will become very ill
I will die
I will faint
I will carry on vomiting for ages
Others will not want to know me
Others will find me repulsive
Other (specify): __________________
Other (specify):__________________

31) In your view‚ what is the most awful aspect of either yourself or others ? Please describe.

…………………………………………………………………………………………

32) This section is for women only (if you are a man‚ please go to question Q33)

a) Have you ever been pregnant?	Yes	No
b) If yes‚ how many times?	Yes	No
c) If yes‚ did you feel sick during any pregnancy?	Yes	No
d) If yes‚ did you vomit during any pregnancy or childbirth?	Yes	No
e) Are you avoiding ha‎ving children because of a fear of vomiting?	Yes	No
f) Have you ever terminated a pregnancy because of a fear of vomiting?	Yes	No

This section is for men. If you are a woman‚ please go to question 34)

33) Have you ever placed on a partner to terminate a pregnancy due to your of ?

Yes No

34) Have you ever avoided an operation with an anaesthetic or a treatment that you have been advised to have because of a of ?

Yes No

If yes‚ please describe the situation

…………………………………………………………………………………………

35) Please tell us any foods that you avoid because of your of (e.g. shellfish; eggs).

Then use the scale below to rate the degree of avoidance of each food if you prepare or cook the food as opposed to someone else preparing the food (e.g. in a restaurant). Then describe any details as to why you avoid it.

0=Never avoid‚ 25= Avoid some of the time‚ 50= Avoid about half of the time ‚ 75=Avoid most of the time‚ 100= Always avoid

Foods avoided (please specify in spaces below)	How much you avoid if you prepare or cook the food (0-100%)	How much you avoid if someone else prepares or cooks the food (e.g. in a restaurant) (0-100%)	Please describe why you avoid this food (e.g. fat content or spiciness of the food‚ previous experience of vomiting )

36) Do you restrict the amount of food you eat either in the hope of preventing yourself from or controlling the amount that you vomit? (Please circle)

Never Sometimes Often Always

37) Do you restrict your food for additional reasons (other than a of )? (Please circle)

Never Sometimes Often Always

Time of day	What do you typically eat?	How much do you restrict what you eat?

If yes to either question‚ please describe what you would eat on a typical day:

38) What is your current weight _________stones ________lbs OR _______kgs

39) What is your current height ______ ft ______ inches OR ________ cms

40) What was your lowest weight at your current height? ______stones_______lbs OR _______kgs

41) Do you excessively smell or check sell by dates of food? (Please circle)

Never Sometimes Often Always

If you do‚ please give details:

…………………………………………………………………………………………

42) Do you check if others are looking or feeling unwell or sick? (Please circle)

Never Sometimes Often Always

If you do‚ please give details:

…………………………………………………………………………………………

43) Do you wash your hands frequently or use special measures (e.g. anti-bacterial soap or very hot water) or wash them for an extra long time? (Please circle)

Never Sometimes Often Always

If you do‚ please give details:

…………………………………………………………………………………………

44) Do you cook your food more than others consider necessary? (Please circle)

Never Sometimes Often Always

If you do‚ please give details:

…………………………………………………………………………………………

45) Do you engage in any rituals (actions that you have to do repeatedly) or counting in an effort to stop yourself ? (please circle)

Never Sometimes Often Always

If you do‚ please give details

…………………………………………………………………………………………

46) Is there anything else you especially look out for or have an urge to check on to prevent the risk of in yourself or others? If yes‚ please give details:

…………………………………………………………………………………………

THIS SECTION IS ONLY FOR THOSE WHO HAVE CHILDREN OR CARE FOR CHILDREN (IF

YOU DO NOT‚ PLEASE GO TO Q48)

47) a) Do you give to your children to stop them from ? (Please circle)

Never Sometimes Often Always

If yes‚ what kind of ?

…………………………………………………………………………………………

b) Do you restrict their movements? (E.g. going to nursery; visiting friends) (Please circle)

Never Sometimes Often Always

If you do‚ please give details:

…………………………………………………………………………………………

c) Have you ever abandoned a small child if he or she started to vomit? (Please circle)

Never Sometimes Often Always

If you do‚ please give details:

…………………………………………………………………………………………

d) Do you get the children in your care to wash their hands frequently or to use special measures (e.g. anti-bacterial soap or very hot water) or to wash them for an extra long time? (Please circle)

Never Sometimes Often Always

If you do‚ please give details:

…………………………………………………………………………………………

e) Is your relationship with your children compromised in any other way because of your of ? (Please circle)

Never Sometimes Often Always

If you are‚ please give details:

…………………………………………………………………………………………

48) PLEASE COMPLETE THIS SECTION IF YOU LIVE WITH A PARTNER OR A CLOSE FRIEND OR RELATIVE (IF NOT‚ PLEASE GO TO Q49)

a) Do you seek from the person/people you live with about whether they look ill or could vomit? If yes‚ how often? (Please circle)

Never Sometimes Often Always

If you do‚ please give details:

…………………………………………………………………………………………

b) Do you attempt to restrict their movements or your joint movements? (Please circle)

Never Sometimes Often Always

If you do‚ please give details:

…………………………………………………………………………………………

49) Please rate the degree to which you avoid or restrict activities because of your of using the scale below.

0=Never avoid‚ 25= Avoid some of the time‚ 50= Avoid about half of the time ‚ 75=Avoid most of the time‚ 100= Always avoid

Activity/Place/ Object avoided because of a fear of vomiting	How much you avoid (0-100%)	Please describe and give details about what you avoid or specific measures you use if you can’t avoid it
Public Toilets
Eating at Restaurants
Eating from salad bars or buffets
Eating food that you have not prepared yourself
Speaking in Public
Sitting Exams
Holidays Abroad
Visiting the Dentist
Attending an Interview
Visiting your GP
Illegal Drugs
Alcohol
Crowded Places
Places where I can’t cook for myself
Drunks
Pubs

Avoidance (continued)

0=Never avoid‚ 25= Avoid some of the time‚ 50= Avoid about half of the time ‚ 75=Avoid most of the time‚ 100= Always avoid

Activity/Place/ Object avoided because of a fear of vomiting	How much you avoid (0-100%)	Please describe and give details about what you avoid or specific measures you use if you do can’t avoid it
Public Transportation (buses‚ trains‚ etc.)
Sea travel by boat
Travel by aero plane
Driving a car
Being a passenger in a car
Visiting others who are ill in hospital
Receiving treatment in hospital
Adults who are ill or might vomit
Children or babies who areill or might vomit
Certain Films or television programs
Fairground Rides
Places that smell of vomit
Certain words relating to vomiting (please give details)		If yes‚ what words do you use?
Foreign holidays (even if the travel was possible)
Other

50) If you have a partner‚ please answer 50a. If you do not have a partner‚ please answer 50b.

a) To what extent does your of currently have an effect on your relationship with an existing partner? (e.g. affectionate feelings‚ number of arguments‚ enjoying activities together)

0-‎-‎-‎-‎-‎-‎-‎-‎-1-‎-‎-‎-‎-‎-‎-‎-‎-2-‎-‎-‎-‎-‎-‎-‎-‎-3-‎-‎-‎-‎-‎-‎-‎-‎-4-‎-‎-‎-‎-‎-‎-‎-‎-5-‎-‎-‎-‎-‎-‎-‎-‎-6-‎-‎-‎-‎-‎-‎-‎-‎-7-‎-‎-‎-‎-‎-‎-‎-‎-8

0= Not at all‚ 2= Slightly‚ 4= Moderately‚ 6= Markedly‚ 8= Extremely

If so‚ how does it affect your relationship?

…………………………………………………………………………………………

b) If you do not have a partner‚ to what extent does your of currently have an effect on dating or developing a relationship?

0= Not at all‚ 2= Slightly‚ 4= Moderately‚ 6= Markedly‚ 8= Extremely

If so‚ how does it affect your ability to date or have a relationship?

…………………………………………………………………………………………

51) To what extent does your of currently have an effect on a sexual relationship? (e.g. enjoyment of sex‚ of sexual activity)

0= Not at all‚ 2= Slightly‚ 4= Moderately‚ 6= Markedly‚ 8= Extremely I avoid sex

If so‚ how?

…………………………………………………………………………………………

….Tick‚ if no sexual relationship for reasons other than avoiding sex because of your problem

52) To what extent does your of currently interfere with your ability to work or study‚ or your as a homemaker? (Please rate this even if you are not working or studying: we are interested in your ability to work or study.)

0= Not at all‚ 2= Slightly‚ 4= Moderately‚ 6= Markedly‚ 8= Very severely I can’t work

If so‚ how does your affect it most?

…………………………………………………………………………………………

How many working days have you lost in the past year because of your ?……

53) To what extent does your of currently interfere with your social life? (with other people‚ e.g. parties‚ pubs‚ clubs‚ outings‚ visits‚ home entertainment)

0= Not at all‚ 2= Slightly‚ 4= Moderately‚ 6= Markedly‚ 8= Very severely

If so‚ how does it affect it most?

…………………………………………………………………………………………

54) To what extent does your of currently interfere with your private leisure activities? (done alone) (e.g. reading; gardening; collecting; walking alone etc)

0= Not at all‚ 2= Slightly‚ 4= Moderately‚ 6= Markedly‚ 8= Very severely

If so‚ how does it affect it most?

…………………………………………………………………………………………

55) To what extent does your of currently interfere with your home management? (e.g. cleaning‚ tidying‚ shopping‚ cooking‚ looking after your home or children‚ paying bills etc)

0= Not at all‚ 2= Slightly‚ 4= Moderately‚ 6= Markedly‚ 8= Very severely

If so‚ how does it affect it most?

…………………………………………………………………………………………

56) On an average day over the past week‚ how much time do you spend worrying about yourself or others ? (This includes thinking about how to prevent it)

________minutes OR _______hours a day

57) To what extent does your worry about preoccupied you over the past week? That is‚you think about it a lot and it is hard to stop thinking about it?

0= Not at all preoccupied‚ 2= slightly preoccupied‚ 4= moderately preoccupied‚ 6= Markedly preoccupied‚ 8= Very Extremely preoccupied

58) How distressing has your of been in the past week?

0= Not at all distressing‚ 2= Slightly‚ 4= Moderately‚ 6= Markedly‚ 8= Extremely distressing

59) How well do you think you would cope with an of in the future?

0= Not at all‚ 2= with difficulty‚ 4= reasonably‚ 6= fairly well‚ 8= very well

60) To what extent do you believe you can influence or prevent yourself from any in the future?

0= Not at all‚ 2= Slightly‚ 4= Moderately‚ 6= Markedly‚ 8= Totally All

61) This next is for treatments that you have had for your of .

Please rate the effectiveness of each that you received using the scale below.

0-‎-‎-‎-‎-‎-‎-‎-‎-1-‎-‎-‎-‎-‎-‎-‎-‎-2-‎-‎-‎-‎-‎-‎-‎-‎-3-‎-‎-‎-‎-‎-‎-‎-‎-4-‎-‎-‎-‎-‎-‎-‎-‎-5-‎-‎-‎-‎-‎-‎-‎-‎-6-‎-‎-‎-‎-‎-‎-‎-‎-7-‎-‎-‎-‎-‎-‎-‎-‎-8-‎-‎-‎-‎-‎-‎-‎-‎-9-‎-‎-‎-‎-‎-‎-‎-‎-10

0= Not effective at all‚ 2= Mildly Effective‚ 4= Moderately Effective‚ 6= Very Effective‚ 8= Extremely Effective‚10= (no longer at all vomit)

a) Have you had behaviour (exposure) or cognitive behaviour ?

Yes No

If yes‚ please give details about what it consisted of‚ when and by whom it was delivered and how effective it was using the scale above?

…………………………………………………………………………………………

b) Have you ever been prescribed and taken any psychiatric for your of ?

Yes No

If yes‚ please give name of and dosage‚ with the dates when you took it‚ and say how effective it was.

…………………………………………………………………………………………

c) Have you had any other types of (e.g. ) for your of ?

Yes No

If yes‚ please describe what it consisted of and give details and how effective it was?

…………………………………………………………………………………………

http://www.kcl.ac.uk/prospectus/graduate/doctorate-in-clinical-psychology

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