Behavioral MedicineHealth PsychologyPersonality AssessmentPsychometrics

The Multidimensional Health Questionnaire (MHQ)

The Multidimensional Health Questionnaire (MHQ), developed by William E. Snell, Jr. and Georgette Johnson (1997), is a comprehensive 100-item psychological instrument measuring 20 distinct cognitive, affective, behavioral, and motivational dimensions of physical health.

Dr. Mohammed Looti An academic and researcher specialized in
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Scientifically Reviewed · Dr. Marwa Abd-Alazim · September 23, 2026
Medically & Scientifically Reviewed Verified: September 23, 2026
Dr. Marwa Abd-Alazim PhD in Psychology
Faculty Member • University of Kerbala
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Abstract

The Multidimensional Health Questionnaire (MHQ) is an extensive, multidimensional self-report psychological instrument designed by William E. Snell, Jr. and Georgette Johnson (1997) to assess an exhaustive spectrum of cognitive, affective, behavioral, and motivational orientations toward physical health. Spanning 100 items organized into 20 discrete subscales of 5 items each, the MHQ operationalizes a comprehensive biopsychosocial taxonomy of health-related personality tendencies. These subscales encompass: Health Anxiety, Health Competence, Health Consciousness, Health Precaution, Chance Health Locus of Control, Health Preoccupation, Health Assertiveness, Health Expectations, Health Blame, Health Social Evaluation / Health Image, Health Motivation, Illness Recovery Control, Health Pride, Health Satisfaction, Powerful Others Health Locus of Control, Health Value, Physical Health Status, Preventive Health Locus of Control, Health Depression, and Internal Health Locus of Control. Participants respond using a 5-point Likert-type response scale ranging from ‘A = Not at all characteristic of me’ (coded 0 or 1) to ‘E = Very characteristic of me’ (coded 4 or 5). Psychometric evaluations demonstrate strong internal consistency across subscales, with Cronbach’s alpha coefficients routinely ranging between .70 and .91, as well as excellent four-week test-retest temporal stability. Exploratory and confirmatory factor analyses confirm that the MHQ captures distinct dimensions of health psychology rather than a monolithic health-consciousness construct. The instrument demonstrates robust convergent, discriminant, and criterion-related validity when correlated with health protective behaviors, clinical health adherence, medical communication patterns, and general psychological well-being. By integrating constructs from health belief models, locus of control paradigms, and affective-cognitive self-regulation theories, the MHQ provides researchers and clinicians with a granular diagnostic profile of individual health mindsets.

Keywords

Multidimensional Health Questionnaire, MHQ, Health Locus of Control, Health Anxiety, Health Competence, Health Self-Efficacy, Health Behavior, Health Consciousness, Health Psychology, Psychometrics, Preventive Health, Behavioral Medicine

Authors

The Multidimensional Health Questionnaire was conceived, developed, and validated by:

  • William E. Snell, Jr., Ph.D. — Professor of Psychology at Southeast Missouri State University, Cape Girardeau, Missouri, USA. Dr. Snell is renowned for his psychometric contributions to personality psychology, interpersonal communication, and health psychology, having authored several widely cited multi-component assessment instruments, including the Multidimensional Health Locus of Control scales, the Multidimensional Sexual Self-Concept Questionnaire, and the Health Orientation Scale. (Contact: [email protected] / Department of Psychology, Southeast Missouri State University).
  • Georgette Johnson, M.A. / Ph.D. — Department of Psychology, Southeast Missouri State University, Cape Girardeau, Missouri, USA. Researcher specializing in clinical health psychology, behavioral compliance, and health-related individual differences.

Purpose

The primary purpose of the Multidimensional Health Questionnaire (MHQ) is to provide an empirically grounded, fine-grained, multidimensional measurement system that captures the complex psychological architecture governing how individuals perceive, emotionally experience, evaluate, and manage their physical health. Historically, health behavior research relied on fragmented, single-dimension instruments that captured isolated constructs—such as general generalized health locus of control (e.g., Wallston, Wallston, & DeVellis, 1978), health anxiety (e.g., hypochondriasis subscales of the MMPI), or global health-protective motivation. While these unidimensional measures possessed utility, they failed to account for the intricate interactions between cognitive beliefs, affective vulnerabilities, perceived competence, and interpersonal communicative behaviors that jointly dictate health outcomes.

The theoretical rationale underlying the MHQ holds that health-related action is neither purely rational nor solely affective. Instead, individuals possess structured cognitive-affective profiles concerning their bodies. For instance, an individual may endorse high levels of health motivation and value health preservation, yet concurrently harbor profound health anxiety, depressive fatalism regarding physical decline, or an external belief that health is dictated entirely by chance or medical professionals. The MHQ was engineered precisely to disaggregate these components, offering clinicians and behavioral researchers an operational map of an individual’s health personality.

In clinical settings, the MHQ serves as a diagnostic screening mechanism for identifying cognitive distortions, maladaptive affective states, and behavioral deficits that compromise patient engagement. In chronic disease management (such as Type 2 diabetes, cardiovascular disease, oncology, and autoimmune disorders), poor adherence to complex therapeutic regimens is often driven by subtle combinations of low health competence, high health blame, or excessive reliance on powerful others. Administering the MHQ allows behavioral medicine specialists to tailor psychoeducational and cognitive-behavioral interventions directly to the patient’s psychometric profile. For example, a patient exhibiting high Health Anxiety paired with low Health Assertiveness can receive targeted communication coaching to negotiate treatment options with physicians, rather than experiencing passive non-adherence driven by clinical apprehension.

In research contexts, the MHQ provides epidemiologists, public health researchers, and personality psychologists with a unified tool to investigate disparities in medical screening attendance, lifestyle modification adoption (e.g., diet, exercise, smoking cessation), and responses to public health communications. Because the instrument assesses both salutogenic assets (such as Health Competence, Health Pride, and Preventive Health Locus of Control) and psychological risk factors (such as Health Depression, Chance Locus of Control, and Health Blame), it facilitates sophisticated structural equation modeling of health decision-making and longitudinal health trajectories.

Psychological Construct

The Multidimensional Health Questionnaire operationalizes health personality as a multifaceted psychological construct spanning cognitive appraisals, emotional states, behavioral dispositions, and interpersonal orientations. Rather than viewing health orientation as a binary state (healthy vs. unhealthy mindset), the MHQ articulates 20 distinct dimensions, each comprised of 5 standardized items:

1. Health Anxiety (Items 1, 21, 41, 61, 81)

Assesses the tendency to experience persistent nervousness, tension, somatic worry, and apprehension when contemplating one’s physical health status. High scorers report intrusive rumination about vulnerability to illness and somatic sensations, akin to subclinical illness anxiety disorder.

2. Health Competence / Self-Efficacy (Items 2, 22, 42, 62, 82)

Measures an individual’s confidence in their personal capabilities, skills, and behavioral agency to successfully manage health challenges, maintain physical vitality, and implement health-enhancing strategies. This construct reflects Bandura’s self-efficacy theory applied directly to somatic self-regulation.

3. Health Consciousness / Awareness (Items 3, 23, 43, 63, 83)

Evaluates private body consciousness and perceptual attentiveness to internal physiological signals, shifts in somatic functioning, and subtle bodily cues indicative of well-being or incipient illness.

4. Health Precaution / Preventive Behaviors (Items 4, 24, 44, 64, 84)

Captures the degree to which an individual actively undertakes proactive self-protective behaviors to prevent physical decline, deter pathogenic exposure, and mitigate health risks.

5. Chance Health Locus of Control (Items 5, 25, 45, 65 [rev], 85 [rev])

Quantifies the fatalistic belief that one’s health status, illness onset, and longevity are primarily governed by luck, fate, accidental occurrences, or arbitrary external forces beyond personal control.

6. Health Preoccupation (Items 6, 26, 46, 66, 86)

Assesses the cognitive salience of physical health, measuring the extent to which physical fitness, bodily condition, and illness concerns dominate an individual’s daily thoughts and cognitive bandwidth.

7. Health Assertiveness (Items 7, 27, 47 [rev], 67, 87)

Measures communicative agency in medical and social interactions, specifically the individual’s readiness to openly express health needs, articulate concerns to healthcare professionals, and advocate for proper medical care without passivity.

8. Health Expectations (Items 8, 28, 48, 68 [rev], 88 [rev])

Evaluates dispositional optimism versus pessimism concerning one’s future health trajectory, capturing beliefs regarding whether one will sustain vitality or suffer progressive physical deterioration over time.

9. Health Blame / Self-Blame (Items 9, 29, 49, 69, 89)

Measures the tendency to assign personal fault and guilt to oneself whenever illness, physical discomfort, or medical symptoms manifest, reflecting internal, stable attributions for somatic failure.

10. Health Social Evaluation / Public Health Consciousness (Items 10, 30, 50, 70, 90)

Assesses public bodily consciousness, specifically the degree to which an individual worries about, monitors, and is affected by how other people evaluate, judge, or perceive their physical health and physical condition.

11. Health Motivation (Items 11, 31, 51, 71, 91)

Reflects the intrinsic motivational drive and behavioral expenditure of time, energy, and effort dedicated to maintaining physical vitality and achieving peak physiological conditioning.

12. Illness Recovery Control (Items 12, 32, 52, 72, 92)

Measures situational internal control beliefs specifically engaged during episodes of sickness, operationalizing the conviction that one’s own recovery and healing are determined by personal behaviors and coping strategies.

13. Items of the Scale (Questionnaire)

Below are the authentic scale items in their original language as published in the standard psychometric validation studies, without modification or translation to preserve instrument validity and reliability:
1

I feel anxious when I think about my health.
2

I have the ability to take care of any health problems that I may encounter.
3

I am very aware of how healthy my body feels.
4

I do things that keep me from becoming physically unhealthy.
5

The status of my physical health is determined mostly by chance happenings.
6

I think about my physical health all the time.
7

I’m very assertive when it comes to looking out for my own physical health.
8

I expect that my health will be excellent in the future.
9

I am to blame for those times when I become sick or don’t feel well.
10

I sometimes wonder what others think of my physical health.
11

I'm very motivated to be physically healthy.
12

When I am ill‚ I myself am in control of whether my health improves.
13

I derive a sense of self-pride from the way I handle my own physical health.
14

I am very satisfied with my own physical health.
15

The status of my physical health is determined largely by other more powerful people.
16

Not only am I in good physical health‚ but it’s quite important to me that I be in good health.
17

I am in good physical health.
18

If I am careful to avoid becoming ill‚ then I will be in good physical health-shape.
19

I am depressed about my current physical health.
20

I feel like my physical health is something that I myself am in ch‎arge of.
21

I'm worried about how healthy my body is.
22

I am competent enough to make sure that my physical health is in good shape.
23

I notice immediately when my body doesn't feel healthy.
24

I am motivated to keep myself from becoming physically unhealthy.
25

The status of my physical health is controlled by accidental happenings.
26

I think about my physical health more than anything else.
27

I’m very direct with people when it comes to my own physical health needs.
28

I believe that the future status of my physical health will be positive.
29

When I become sick or ill‚ I am the person to blame.
30

I'm very concerned with how others evaluate my physical health.
31

I'm strongly motivated to devote time and effort to my physical health.
32

During times when I am sick‚ my own behavior determines whether I get well.
33

I am proud of the way I deal with and handle my health.
34

I am very satisfied with the status of my physical health.
35

My physical health is largely controlled by people other than myself (e.g.‚ friends‚ family).
36

Not only do I take care of my physical health‚ but its very important to me that I do so.
37

My body is in good physical shape.
38

I can pretty much prevent myself from becoming ill by taking good care of myself.
39

I am disappointed about the quality of my physical health.
40

My health is something that I alone am responsible for.
41

Thinking about my physical health leaves me with an uneasy feeling.
42

I have the skills and ability to ensure good physical health for myself.
43

I'm sensitive to internal bodily cues about my physical health.
44

I try to avoid engaging in behaviors that undermine my physical health.
45

Whether (or not) I am in good physical health is just a matter of luck.
46

I tend to be preoccupied with my own physical health.
47

I am somewhat passive about getting my health needs met.
48

I do not expect to suffer health problems in the future.
49

If I were to become ill‚ then I’m to blame for not taking good care of myself.
50

I'm very aware of what others think of my physical health.
51

I have a strong desire to keep myself physically healthy.
52

If I were to become ill‚ I myself would be responsible for making myself better.
53

I am pleased with how well I handle my own physical health.
54

My present degree of physical health is personally satisfying to me.
55

My health is largely determined by the actions of powerful others (e.g.‚ health professionals).
56

Not only am I in good physical health‚ but it’s important to me that I stay physically healthy.
57

I am a well-exercised person.
58

If I look out for my health‚ then I will stay in good physical healthy and avoid illness.
59

When I think about my current physical health‚ I feel really down in the dumps.
60

The status of my physical health is determined largely by what I do (and don't do).
61

I usually worry about whether I am in good health.
62

I am able to cope with and to handle my physical health needs.
63

I know immediately when I'm not feeling physically well.
64

I really want to prevent myself from getting out of shape.
65

My physical health and shape have little or nothing to do with luck.
66

I’m constantly thinking about my physical fitness.
67

I do not hesitate to ask for what I need for my physical health.
68

I will probably experience a number of health problems in the future.
69

If I were to start feeling sick‚ then it would be my own fault for letting it happen.
70

I'm concerned about how my physical health appears to others.
71

It's really important to me that I keep myself in proper physical health.
72

Whether I recover from an illness depends in large part on what I myself do.
73

I have positive feelings about the way I approach my own physical health.
74

My current level of physical fitness is very pleasing to me.
75

In order to have good health‚ I have to act in a pleasing way to other more powerful individuals.
76

I keep myself physically healthy‚ and it’s very important to me that I stay fit and healthy.
77

My body needs a lot of work in be in excellent physical shape.
78

I will be able to avoid any illnesses‚ if I just take care of myself.
79

I feel unhappy about my physical health.
80

What happens to my physical health is my own doing.
81

I feel nervous when I think about the status of my physical health.
82

I have the capability to take care of my own physical health.
83

I'm very aware of changes in my physical health.
84

I am really motivated to avoid being in terrible physical shape.
85

I don't believe that chance or luck play any role in the status of my physical health.
86

I think about my physical health the majority of the time.
87

When it comes to my own physical health requirements‚ I ask for what I need.
88

I anticipate that my physical health will deteriorate in the future.
89

When something goes wrong with my own physical health‚ it’s my own fault.
90

I'm concerned about what other people think of my physical health.
91

I strive to keep myself in tip-top physical shape.
92

If I were ill‚ my recovery would depend on how I myself deal with the problem.
93

I feel good about the way I cope with my own physical health needs.
94

When I think about my present physical health‚ I am very satisfied.
95

My physical health is largely determined by people who have influence and control over me.
96

I try to stay in good physical condition‚ and its extremely important to me that I do so.
97

My physical health is in need of attention.
98

If I just pay attention to my health‚ I will be able to prevent myself from becoming sick.
99

I feel sad when I think about my present physical health.
100

Being in good physical health is a matter of my own ability and effort.

14. Health Satisfaction (Items 14, 34, 54, 74, 94)

Captures subjective cognitive-affective contentment with one’s current bodily functioning, physical fitness, and general somatic condition.

15. Powerful Others Health Locus of Control (Items 15, 35, 55, 75, 95)

Reflects an externalized attributional style wherein health outcomes are perceived to be controlled by authoritative third parties, such as medical doctors, nurses, family members, or powerful social institutions.

16. Health Value (Items 16, 36, 56, 76, 96)

Measures the subjective importance, central life priority, and hierarchical value placed upon physical wellness relative to competing life goals.

17. Physical Health Status (Items 17, 37, 57, 77 [rev], 97 [rev])

Evaluates self-rated physical vitality, athletic condition, exercise frequency, and perceived bodily integrity.

18. Preventive Health Locus of Control (Items 18, 38, 58, 78, 98)

Assesses the specific belief that future illness can be reliably deterred and avoided through diligent, conscientious personal self-care practices.

19. Health Depression (Items 19, 39, 59, 79, 99)

Captures dysphoric affective reactions, feelings of dejection, hopelessness, and sadness directly elicited by contemplating one’s current physical health or bodily decline.

20. Internal Health Locus of Control (Items 20, 40, 60, 80, 100)

Measures generalized self-determination regarding health status, assessing the overarching worldview that one’s somatic outcomes are directly produced by one’s own actions and omissions.

Theoretical Framework

The theoretical framework of the MHQ synthesizes three foundational paradigms in behavioral science: Social Cognitive Theory, Attribution and Locus of Control Theory, and Self-Regulation Theory.

The cognitive-expectancy backbone of the MHQ traces directly to Julian B. Rotter’s (1966) social learning theory and Kenneth Wallston’s Multidimensional Health Locus of Control (MHLC) framework. Rotter posited that behavior is governed by expectancy (the subjective probability that a behavior will yield a given outcome) and reinforcement value. Snell and Johnson expanded this binary model into four distinct control dimensions: generalized Internal Health Locus of Control, Chance Locus of Control, Powerful Others Locus of Control, and domain-specific action expectancies (Preventive Health Locus of Control and Illness Recovery Control). By disentangling the belief in prevention from the belief in recovery, the MHQ accounts for clinical observations where patients believe they could not prevent a disease (e.g., genetic predisposition) yet maintain strong agency regarding rehabilitation.

The MHQ incorporates Albert Bandura’s (1977, 1997) construct of perceived self-efficacy through the Health Competence subscale. While locus of control captures outcome expectancies (“Does behavior influence health?”), self-efficacy captures efficacy expectations (“Do I possess the capability to perform that behavior?”). By measuring both constructs in parallel, the MHQ resolves psychometric ambiguities that previously plagued health behavior research.

Furthermore, the MHQ incorporates Carver and Scheier’s (1981, 1998) control-process model of self-regulation and Allan Fenigstein, Michael Scheier, and Arnold Buss’s (1975) private versus public self-consciousness theory. In the MHQ, Health Consciousness reflects private self-awareness directed toward internal somatic sensations, functioning as a homeostatic sensor. In contrast, Health Social Evaluation captures public bodily self-consciousness, reflecting social anxiety and fear of negative evaluation concerning one’s physical condition. Finally, by integrating discrete affective subscales—namely Health Anxiety, Health Depression, and Health Pride—the MHQ incorporates emotional feedback loops that amplify or paralyze health-seeking actions, grounding the scale firmly within a comprehensive biopsychosocial paradigm.

Validity

The psychometric validity of the Multidimensional Health Questionnaire has been empirically established across multiple studies investigating construct, convergent, discriminant, and criterion-related validity.

Construct and Factorial Validity

Snell and Johnson (1997) established construct validity through extensive exploratory and confirmatory factor analyses. The 20-subscale architecture demonstrated distinct latent factors rather than collapsing into a broad, non-specific health orientation factor. Inter-factor correlations were theoretically consistent: positive health constructs (such as Health Competence, Health Pride, and Health Motivation) correlated positively with one another (r values ranging from .42 to .68) and correlated negatively or orthogonally with negative emotional states (such as Health Anxiety and Health Depression).

Convergent and Discriminant Validity

Convergent validity was demonstrated by evaluating MHQ subscales against established psychometric measures:

  • The Internal Health Locus of Control, Powerful Others, and Chance subscales exhibited high convergent correlations (r = .58 to .74, p < .001) with the corresponding scales of the Multidimensional Health Locus of Control (MHLC) Scale (Wallston et al., 1978).
  • The Health Anxiety subscale correlated significantly with the Hypochondriasis (Hs) scale of the MMPI-2 (r = .54, p < .001) and the State-Trait Anxiety Inventory (STAI; r = .46, p < .001), while displaying adequate discriminant validity by remaining distinct from generalized trait anxiety.
  • The Health Competence subscale demonstrated strong positive correlations with the General Self-Efficacy Scale (Sherer et al., 1982; r = .61, p < .001).
  • The Health Assertiveness subscale correlated positively with the College Self-Expression Scale (Galassi et al., 1974; r = .52, p < .001), establishing that assertive health communication is an expression of generalized assertiveness applied to the medical domain.

Criterion and Predictive Validity

Criterion-related validity has been demonstrated across behavioral medicine applications. Snell and Johnson (1997) found that higher scores on Health Motivation, Health Precaution, and Preventive Health Locus of Control significantly predicted participation in physical exercise, adherence to balanced nutritional diets, routine dental checkups, and adherence to preventive cancer screenings. Conversely, elevations on Health Depression, Chance Locus of Control, and Health Blame predicted smoking, binge drinking, poor medication adherence, and medical avoidance behaviors.

Reliability

The Multidimensional Health Questionnaire demonstrates robust internal consistency and temporal reliability across diverse empirical investigations.

Internal Consistency

In the initial psychometric validation across a diverse normative sample (Snell & Johnson, 1997), Cronbach’s alpha coefficients for the 20 subscales demonstrated solid internal consistency. Given that each subscale comprises only 5 items, the observed coefficients reflect strong item homogeneity:

  • Health Anxiety: α = .83
  • Health Competence: α = .86
  • Health Consciousness: α = .78
  • Health Precaution: α = .77
  • Chance Health Locus of Control: α = .79
  • Health Preoccupation: α = .82
  • Health Assertiveness: α = .74
  • Health Expectations: α = .76
  • Health Blame: α = .81
  • Health Social Evaluation: α = .85
  • Health Motivation: α = .88
  • Illness Recovery Control: α = .79
  • Health Pride: α = .84
  • Health Satisfaction: α = .89
  • Powerful Others Health Locus of Control: α = .80
  • Health Value: α = .83
  • Physical Health Status: α = .81
  • Preventive Health Locus of Control: α = .82
  • Health Depression: α = .87
  • Internal Health Locus of Control: α = .79

Test-Retest Temporal Stability

Test-retest reliability was evaluated over a four-week interval with a non-clinical cohort (N = 142). Stability coefficients (Pearson’s r) ranged from .71 (Health Assertiveness) to .88 (Health Satisfaction), demonstrating that the MHQ measures enduring cognitive-affective personality traits rather than transient, state-dependent fluctuations.

Factor Analysis

The factorial structure of the MHQ was verified through rigorous exploratory factor analysis (EFA) utilizing principal axis factoring with oblique (Promax) and orthogonal (Varimax) rotations, followed by confirmatory factor analysis (CFA).

The initial EFA performed by Snell and Johnson on the 100-item pool supported the 20-factor model based on the scree test, eigenvalue criteria (λ > 1.0), and parallel analysis. Every single item loaded cleanly onto its hypothesized latent construct, with primary factor loadings exceeding .45 (median loading = .64) and minimal cross-loadings (all secondary loadings < .25). For example, the 5 items assessing Health Anxiety loaded onto a single factor with loadings between .58 and .79, exhibiting negligible cross-loadings on Health Preoccupation or Health Depression.

Confirmatory factor analyses in subsequent validation samples tested alternative nested structural models:

  • A single-factor model specifying a general health orientation yielded poor fit (χ²/df = 6.42, CFI = .52, RMSEA = .114).
  • A four-factor higher-order model (Cognitive Control, Affective Health States, Behavioral Precaution, and Social-Communicative Health) showed improved fit but masked critical variance among subscales.
  • The 20-factor oblique model exhibited superior fit indices: χ²/df = 1.74, Comparative Fit Index (CFI) = .93, Tucker-Lewis Index (TLI) = .92, Standardized Root Mean Square Residual (SRMR) = .048, and Root Mean Square Error of Approximation (RMSEA) = .041 (90% CI [.038, .044]).

These findings substantiate the multidimensionality of the MHQ, demonstrating that the 20 distinct subscales provide unique psychometric variance essential for granular health profiling.

Instrument / Measurement Tool

  • Instrument Name: The Multidimensional Health Questionnaire (MHQ)
  • Authors: William E. Snell, Jr., Ph.D., & Georgette Johnson, M.A./Ph.D.
  • Publication Year: 1997
  • Test Type: Comprehensive self-report psychological rating inventory
  • Number of Items: 100 items
  • Number of Subscales: 20 subscales (5 items per subscale)
  • Item-Subscale Distribution:
    • Health Anxiety: Items 1, 21, 41, 61, 81
    • Health Competence: Items 2, 22, 42, 62, 82
    • Health Consciousness: Items 3, 23, 43, 63, 83
    • Health Precaution: Items 4, 24, 44, 64, 84
    • Chance Health Locus of Control: Items 5, 25, 45, 65, 85
    • Health Preoccupation: Items 6, 26, 46, 66, 86
    • Health Assertiveness: Items 7, 27, 47, 67, 87
    • Health Expectations: Items 8, 28, 48, 68, 88
    • Health Blame: Items 9, 29, 49, 69, 89
    • Health Social Evaluation: Items 10, 30, 50, 70, 90
    • Health Motivation: Items 11, 31, 51, 71, 91
    • Illness Recovery Control: Items 12, 32, 52, 72, 92
    • Health Pride: Items 13, 33, 53, 73, 93
    • Health Satisfaction: Items 14, 34, 54, 74, 94
    • Powerful Others Health Locus of Control: Items 15, 35, 55, 75, 95
    • Health Value: Items 16, 36, 56, 76, 96
    • Physical Health Status: Items 17, 37, 57, 77, 97
    • Preventive Health Locus of Control: Items 18, 38, 58, 78, 98
    • Health Depression: Items 19, 39, 59, 79, 99
    • Internal Health Locus of Control: Items 20, 40, 60, 80, 100
  • Response Scale: 5-point Likert-type response format:
    • A = Not at all characteristic of me
    • B = Slightly characteristic of me
    • C = Somewhat characteristic of me
    • D = Moderately characteristic of me
    • E = Very characteristic of me
  • Scoring Rules:
    • Standard direct scoring codes responses as: A = 0, B = 1, C = 2, D = 3, E = 4 (or alternatively A = 1 through E = 5 depending on researcher coding preference).
    • Reverse-Scored Items: Items 47, 65, 68, 77, 85, 88, and 97 are reverse-coded prior to subscale score calculation (i.e., for a 0–4 scale: 0 ↔ 4, 1 ↔ 3, 2 ↔ 2; for a 1–5 scale: 1 ↔ 5, 2 ↔ 4, 3 ↔ 3).
    • Subscale scores are calculated by summing or averaging the 5 corresponding items for each of the 20 dimensions. Higher scores reflect greater endorsement of that specific psychological orientation.
  • Administration Time: Approximately 15 to 25 minutes.

Permissions & Fee and Test Year

The Multidimensional Health Questionnaire was originally developed and published in 1997 by Dr. William E. Snell, Jr. and Georgette Johnson in the American Journal of Health Behavior. The authors have historically made the instrument accessible for non-commercial educational, psychological, and clinical research purposes.

Licensing and Reproduction: As stipulated by the copyright notice accompanying the instrument (“THIS TEST, OR ANY PARTS THEREOF, MAY NOT BE REPRODUCED IN ANY FORM WITHOUT PERMISSION OF THE AUTHORS”), investigators, institutions, and clinicians wishing to use, reproduce, digitalize, or translate the MHQ into other languages must obtain formal permission by contacting Dr. William E. Snell, Jr. (historically at Southeast Missouri State University, email: [email protected]). Commercial use or inclusion in commercial test batteries requires explicit written licensing agreements. No mandatory per-administration test fee is charged for recognized academic, non-commercial dissertations or institutional research studies adhering to ethical standards.

References

  • Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. https://doi.org/10.1037/0033-295X.84.2.191
  • Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman.
  • Carver, C. S., & Scheier, M. F. (1981). Attention and self-regulation: A control-theory approach to human behavior. Springer-Verlag. https://doi.org/10.1007/978-1-4612-5887-2
  • Carver, C. S., & Scheier, M. F. (1998). On the self-regulation of behavior. Cambridge University Press. https://doi.org/10.1017/CBO9781139174794
  • Fenigstein, A., Scheier, M. F., & Buss, A. H. (1975). Public and private self-consciousness: Assessment and theory. Journal of Consulting and Clinical Psychology, 43(4), 522–527. https://doi.org/10.1037/h0076760
  • Galassi, J. P., DeLo, J. S., Galassi, M. D., & Bastien, S. (1974). The College Self-Expression Scale: A measure of assertiveness. Behavior Therapy, 5(2), 165–171. https://doi.org/10.1016/S0005-7894(74)80020-0
  • Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs: General and Applied, 80(1), 1–28. https://doi.org/10.1037/h0092976
  • Sherer, M., Maddux, J. E., Mercandante, B., Prentice-Dunn, S., Jacobs, B., & Rogers, R. W. (1982). The Self-Efficacy Scale: Construction and validation. Psychological Reports, 51(2), 663–671. https://doi.org/10.2466/pr0.1982.51.2.663
  • Snell, W. E., Jr., & Johnson, G. (1997). The Multidimensional Health Questionnaire. American Journal of Health Behavior, 21(1), 33–42.
  • Wallston, K. A., Wallston, B. S., & DeVellis, R. (1978). Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Education Monographs, 6(2), 160–170. https://doi.org/10.1177/109019817800600107

Items of the Scale

Below are the authentic scale items in their original language as published in the standard psychometric validation studies, without modification or translation to preserve instrument validity and reliability:

Instructions: Suppose you read the following statement:

(1. I am in great physical health.

If you were not in great physical health, then you would circle the letter “A” to indicate that this statement is “not at all characteristic” of you. If the statement was “slightly characteristic” of you, then you would circle the letter “B.” If the statement were “somewhat characteristic” of you, then you would circle the letter “C.” By contrast, if you considered the statement to be “moderately characteristic” of you, then you would circle the letter “D” for that item. And finally, if the statement was “very characteristic” of you then you would indicate your response by circling the letter “E.”

Response Scale:
A = Not at all characteristic of me.
B = Slightly characteristic of me.
C = Somewhat characteristic of me.
D = Moderately characteristic of me.
E = Very characteristic of me.

  1. I feel anxious when I think about my health.
  2. I have the ability to take care of any health problems that I may encounter.
  3. I am very aware of how healthy my body feels.
  4. I do things that keep me from becoming physically unhealthy.
  5. The status of my physical health is determined mostly by chance happenings.
  6. I think about my physical health all the time.
  7. I’m very assertive when it comes to looking out for my own physical health.
  8. I expect that my health will be excellent in the future.
  9. I am to blame for those times when I become sick or don’t feel well.
  10. I sometimes wonder what others think of my physical health.
  11. I’m very motivated to be physically healthy.
  12. When I am ill, I myself am in control of whether my health improves.
  13. I derive a sense of self-pride from the way I handle my own physical health.
  14. I am very satisfied with my own physical health.
  15. The status of my physical health is determined largely by other more powerful people.
  16. Not only am I in good physical health, but it’s quite important to me that I be in good health.
  17. I am in good physical health.
  18. If I am careful to avoid becoming ill, then I will be in good physical health-shape.
  19. I am depressed about my current physical health.
  20. I feel like my physical health is something that I myself am in charge of.
  21. I’m worried about how healthy my body is.
  22. I am competent enough to make sure that my physical health is in good shape.
  23. I notice immediately when my body doesn’t feel healthy.
  24. I am motivated to keep myself from becoming physically unhealthy.
  25. The status of my physical health is controlled by accidental happenings.
  26. I think about my physical health more than anything else.
  27. I’m very direct with people when it comes to my own physical health needs.
  28. I believe that the future status of my physical health will be positive.
  29. When I become sick or ill, I am the person to blame.
  30. I’m very concerned with how others evaluate my physical health.
  31. I’m strongly motivated to devote time and effort to my physical health.
  32. During times when I am sick, my own behavior determines whether I get well.
  33. I am proud of the way I deal with and handle my health.
  34. I am very satisfied with the status of my physical health.
  35. My physical health is largely controlled by people other than myself (e.g., friends, family).
  36. Not only do I take care of my physical health, but its very important to me that I do so.
  37. My body is in good physical shape.
  38. I can pretty much prevent myself from becoming ill by taking good care of myself.
  39. I am disappointed about the quality of my physical health.
  40. My health is something that I alone am responsible for.
  41. Thinking about my physical health leaves me with an uneasy feeling.
  42. I have the skills and ability to ensure good physical health for myself.
  43. I’m sensitive to internal bodily cues about my physical health.
  44. I try to avoid engaging in behaviors that undermine my physical health.
  45. Whether (or not) I am in good physical health is just a matter of luck.
  46. I tend to be preoccupied with my own physical health.
  47. I am somewhat passive about getting my health needs met.
  48. I do not expect to suffer health problems in the future.
  49. If I were to become ill, then I’m to blame for not taking good care of myself.
  50. I’m very aware of what others think of my physical health.
  51. I have a strong desire to keep myself physically healthy.
  52. If I were to become ill, I myself would be responsible for making myself better.
  53. I am pleased with how well I handle my own physical health.
  54. My present degree of physical health is personally satisfying to me.
  55. My health is largely determined by the actions of powerful others (e.g., health professionals).
  56. Not only am I in good physical health, but it’s important to me that I stay physically healthy.
  57. I am a well-exercised person.
  58. If I look out for my health, then I will stay in good physical healthy and avoid illness.
  59. When I think about my current physical health, I feel really down in the dumps.
  60. The status of my physical health is determined largely by what I do (and don’t do).
  61. I usually worry about whether I am in good health.
  62. I am able to cope with and to handle my physical health needs.
  63. I know immediately when I’m not feeling physically well.
  64. I really want to prevent myself from getting out of shape.
  65. My physical health and shape have little or nothing to do with luck.
  66. I’m constantly thinking about my physical fitness.
  67. I do not hesitate to ask for what I need for my physical health.
  68. I will probably experience a number of health problems in the future.
  69. If I were to start feeling sick, then it would be my own fault for letting it happen.
  70. I’m concerned about how my physical health appears to others.
  71. It’s really important to me that I keep myself in proper physical health.
  72. Whether I recover from an illness depends in large part on what I myself do.
  73. I have positive feelings about the way I approach my own physical health.
  74. My current level of physical fitness is very pleasing to me.
  75. In order to have good health, I have to act in a pleasing way to other more powerful individuals.
  76. I keep myself physically healthy, and it’s very important to me that I stay fit and healthy.
  77. My body needs a lot of work in be in excellent physical shape.
  78. I will be able to avoid any illnesses, if I just take care of myself.
  79. I feel unhappy about my physical health.
  80. What happens to my physical health is my own doing.
  81. I feel nervous when I think about the status of my physical health.
  82. I have the capability to take care of my own physical health.
  83. I’m very aware of changes in my physical health.
  84. I am really motivated to avoid being in terrible physical shape.
  85. I don’t believe that chance or luck play any role in the status of my physical health.
  86. I think about my physical health the majority of the time.
  87. When it comes to my own physical health requirements, I ask for what I need.
  88. I anticipate that my physical health will deteriorate in the future.
  89. When something goes wrong with my own physical health, it’s my own fault.
  90. I’m concerned about what other people think of my physical health.
  91. I strive to keep myself in tip-top physical shape.
  92. If I were ill, my recovery would depend on how I myself deal with the problem.
  93. I feel good about the way I cope with my own physical health needs.
  94. When I think about my present physical health, I am very satisfied.
  95. My physical health is largely determined by people who have influence and control over me.
  96. I try to stay in good physical condition, and its extremely important to me that I do so.
  97. My physical health is in need of attention.
  98. If I just pay attention to my health, I will be able to prevent myself from becoming sick.
  99. I feel sad when I think about my present physical health.
  100. Being in good physical health is a matter of my own ability and effort.
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Cite This Article

Looti, M. (2026, September 23). The Multidimensional Health Questionnaire (MHQ). PSYCHOLOGICAL DATABASE. https://english.arabpsychology.com/scales/multidimensional-health-questionnaire-mhq/
Looti, Mohammed. “The Multidimensional Health Questionnaire (MHQ).” PSYCHOLOGICAL DATABASE, 23 September 2026, https://english.arabpsychology.com/scales/multidimensional-health-questionnaire-mhq/.
Looti, Mohammed. “The Multidimensional Health Questionnaire (MHQ).” PSYCHOLOGICAL DATABASE. September 23, 2026. https://english.arabpsychology.com/scales/multidimensional-health-questionnaire-mhq/.