Taylor Peter J, Pyle Melissa, Schwannauer Matthias, Hutton Paul, Morrison Anthony
Institute of Psychology, Health & Society, University of Liverpool, UK.
Psychosis Research Unit, Greater Manchester West NHS Mental Health Foundation Trust, Manchester, UK.
Br J Clin Psychol. 2015 Nov;54(4):361-77. doi: 10.1111/bjc.12079. Epub 2015 Mar 6.
Negative beliefs about psychosis and other mental health difficulties may contribute to depression and distress in individuals with these experiences. The Personal Beliefs about Experience Questionnaire (PBEQ) and Personal Beliefs about Illness Questionnaire (PBIllQ) are two widely used measures of these beliefs. It is currently uncertain how the items on these measures map onto different underlying factors. This study therefore aimed to test the factor structure of these two measures.
Confirmatory factor analysis (CFA) was used to test three alternative, pre-specified, factor structures for the PBIllQ and PBEQ in a sample of individuals diagnosed with bipolar disorder (n = 202) and a sample of individuals with experien-ces of psychosis (n = 362). Associations with depressive symptoms were also examined.
A three-factor structure was supported for both measures, which included Negative Expectations/Appraisals (NEA), Internal Shame/Defectiveness (ISD) and External Shame (ES) factors. The NEA and ISD subscales also had consistent independent associations with depressive symptoms.
The results suggest that the PBIllQ and PBEQ may capture three distinct sets of negative beliefs in individuals with psychosis or bipolar disorder and that these beliefs may have important consequences for subsequent difficulties in these populations such as depression. Both measures may be helpful in supporting assessment and formulation in clinical practice and in evaluating belief change in intervention trials. However, when used in these settings, the three subscales identified in this study may be the most valid way of calculating scores on these measures.
Negative personal beliefs about the causes, meaning and consequences of psychosis and bipolar disorder are associated with greater distress and depression. Two related measures, the PBIllQ and PBEQ, have been developed to assess these beliefs. Our analyses suggest that scores on these questionnaires are best broken down into three subscales which capture perceptions of internal shame or defectiveness, general negative appraisals and perceptions of external shame. These subscales may capture key underlying sets of negative beliefs within individuals with psychosis or bipolar disorder, which in turn impact upon well-being, such as being associated with greater depression. These subscales can be used to aid assessment and formulation within clinical practice but may also provide a valuable means of assessing changes in negative beliefs following interventions.
对精神病及其他心理健康问题的消极信念可能会导致有这些经历的个体出现抑郁和痛苦。《关于经历的个人信念问卷》（PBEQ）和《关于疾病的个人信念问卷》（PBIllQ）是两种广泛用于测量这些信念的工具。目前尚不确定这些工具上的条目如何映射到不同的潜在因素上。因此，本研究旨在检验这两种工具的因子结构。
采用验证性因子分析（CFA），在诊断为双相情感障碍的个体样本（n = 202）和有精神病经历的个体样本（n = 362）中，对PBIllQ和PBEQ的三种预先指定的替代因子结构进行检验。还研究了与抑郁症状的关联。
两种工具均支持三因子结构，其中包括消极期望/评价（NEA）、内在羞耻/缺陷感（ISD）和外在羞耻（ES）因子。NEA和ISD分量表也与抑郁症状存在一致的独立关联。
结果表明，PBIllQ和PBEQ可能捕捉到了患有精神病或双相情感障碍的个体中三组不同的消极信念，并且这些信念可能会对这些人群随后出现的诸如抑郁等问题产生重要影响。这两种工具在支持临床实践中的评估和诊断以及评估干预试验中的信念变化方面可能会有所帮助。然而，在这些情况下使用时，本研究中确定的三个分量表可能是计算这些工具得分的最有效方式。
对精神病和双相情感障碍的原因、意义及后果的消极个人信念与更大的痛苦和抑郁相关。已开发出两种相关工具，即PBIllQ和PBEQ，来评估这些信念。我们的分析表明，这些问卷的得分最好分解为三个分量表，它们分别捕捉内在羞耻或缺陷感、一般消极评价以及外在羞耻感。这些分量表可能捕捉到了患有精神病或双相情感障碍的个体中关键的潜在消极信念集，进而影响幸福感，比如与更严重的抑郁相关。这些分量表可用于辅助临床实践中的评估和诊断，但也可能提供一种评估干预后消极信念变化的有价值方法。
