Panic Safety Seeking Behaviours Questionnaire – Adapted (PSSBQ-Adapted)

Overview

The Panic Safety Seeking Behaviours Questionnaire – Adapted (PSSBQ-adapted) is a self-report measure assessing the frequency of panic-related safety-seeking behaviours in young people. It is an adolescent adaptation of the Panic Safety Seeking Behaviours Questionnaire developed by Clark and Salkovskis (2009). The adapted questionnaire asks young people how often they engage in a range of safety-seeking behaviours when they are at their most anxious or panicky. Adaptations were informed by consultation with young people and included changes to wording and the addition of an item relating to carrying or drinking water. The PSSBQ-adapted has been evaluated in adolescents aged 12–17 years with panic disorder, adolescents with other anxiety disorders, and a non-clinical community comparison group. Preliminary evidence indicates that panic-related safety-seeking behaviours measured by the PSSBQ-adapted are elevated in adolescents with panic disorder and are associated with panic disorder symptom severity.

Scoring & Interpretation

The PSSBQ-adapted contains 16 specified panic-related safety-seeking behaviours and space for respondents to add up to three additional behaviours. Respondents indicate how often they engage in each behaviour when they are at their most anxious or panicky using a four-point response scale: Never, Sometimes, Often and Always. Responses are scored from 0 to 3. Higher scores indicate more frequent engagement in panic-related safety-seeking behaviours. No clinical cut-off or established clinical threshold has been reported.

Psychometric Properties

Internal Consistency

In a sample of 101 adolescents aged 12–17 years, including adolescents with panic disorder, adolescents with other anxiety disorders and community controls, the PSSBQ-adapted demonstrated good internal consistency (Cronbach's α = .76; McDonald's ω = .82; McCall et al., 2025).

Test-Retest Reliability

No published evidence of test–retest reliability has been identified for the PSSBQ-adapted.

Factor Structure

The factor structure of the PSSBQ-adapted has not yet been established. No published exploratory or confirmatory factor analysis has been identified.

Validity

Preliminary evidence of known-groups and concurrent/construct validity has been reported by McCall et al. (2025). The PSSBQ-adapted differentiated adolescents with panic disorder from adolescents with other anxiety disorders and from non-clinical community controls. Adolescents with panic disorder reported significantly higher levels of safety-seeking behaviours than both the clinical anxiety control group (b = –4.01, SE = 1.67, p < .05) and community control group (b = –6.96, SE = 1.63, p < .001).
Across the sample, higher levels of safety-seeking behaviours measured by the PSSBQ-adapted were also significantly positively associated with greater concurrent panic disorder symptom severity. These findings provide preliminary evidence that the PSSBQ-adapted assesses a behavioural process relevant to adolescent panic disorder. However, comprehensive validation of the measure has not yet been undertaken.

Measurement Invariance

Measurement invariance has not been evaluated.

Access

The PSSBQ-adapted is publicly available as part of the University of Oxford/OxCADAT Brief Cognitive Therapy for Panic Disorder in Adolescents resources. The questionnaire is included in the adolescent panic disorder questionnaire pack.

Users wishing to reproduce, adapt, distribute or incorporate the questionnaire into other resources should confirm the applicable permissions with the measure developers/copyright holders.