From the Biostatistics & Health Informatics Department (Ryan, Vitoratou, Goldsmith), Centre of Implementation Science, Health Services and Population Research Department (Vitoratou), Institute of Psychiatry, Psychology and Neuroscience (IOPPN), King's College London; Quality Improvement Team (Vitoratou), South London and Maudsley NHS Foundation Trust; Academic Department of Psychological Medicine (Chalder), Institute of Psychiatry, Psychology and Neuroscience (IOPPN), King's College London, Weston Education Centre; and South London and Maudsley NHS Foundation Trust (Chalder), London, United Kingdom.
Psychosom Med. 2018 Feb/Mar;80(2):230-237. doi: 10.1097/PSY.0000000000000536.
Symptoms of chronic fatigue syndrome (CFS) can be perpetuated by cognitive and behavioral responses to the illness. We aimed to determine the factor structure, reliability, and validity of the 40-item Cognitive and Behavioural Responses Questionnaire (CBRQ) using data gathered from CFS patients. We also propose a short-version CBRQ for greater clinical utility.
The psychometric analysis was performed on data sets drawn from two sources: a clinical service for CFS patients (n = 576) and the PACE randomized controlled trial of CFS treatments (n = 640). An exploratory factor analysis was conducted on the clinical data set and a confirmatory factor analysis was performed on the randomized controlled trial data set. Using these results, a short version of the CBRQ was proposed. Reliability, metric invariance across age and sex, and construct validity were assessed.
The exploratory factor analysis (relative χ = 2.52, root mean square error of approximation = 0.051, comparative fit index = 0.964, Taylor-Lewis Index = 0.942) and confirmatory factor analysis (relative χ = 4.029, root mean square error of approximation = 0.069, comparative fit index = 0.901, Taylor-Lewis Index = 0.892) revealed that eight-factor models fitted the data well. Satisfactory Cronbach's α values were obtained for the final subscales (≥0.76). The shortened CBRQ was obtained by removing items that cross-loaded onto other factors and/or were the lowest loading items in each factor. The shortened CBRQ contained 18 items that had high factor loadings, good face validity, and reliability (Cronbach's α = 0.67-0.88).
The CBRQs, long and short versions, are reliable and valid scales for measuring cognitive and behavioral responses of patients with CFS. Further research is needed to examine the utility of the CBRQ in other long-term conditions.
慢性疲劳综合征（CFS）的症状可能会因对疾病的认知和行为反应而持续存在。我们旨在使用从 CFS 患者中收集的数据确定 40 项认知和行为反应问卷（CBRQ）的结构因素、可靠性和有效性。我们还提出了一个简短版本的 CBRQ，以提高临床实用性。
使用来自两个来源的数据集进行心理计量分析：CFS 患者的临床服务（n=576）和 CFS 治疗的 PACE 随机对照试验（n=640）。对临床数据集进行探索性因素分析，并对随机对照试验数据集进行验证性因素分析。根据这些结果，提出了 CBRQ 的简短版本。评估了可靠性、年龄和性别之间的度量不变性以及结构有效性。
探索性因素分析（相对 χ=2.52，均方根误差逼近=0.051，比较拟合指数=0.964，泰勒-刘易斯指数=0.942）和验证性因素分析（相对 χ=4.029，均方根误差逼近=0.069，比较拟合指数=0.901，泰勒-刘易斯指数=0.892）表明，八项因素模型很好地拟合了数据。最终子量表的 Cronbach's α 值令人满意（≥0.76）。通过删除跨加载到其他因素上的项目和/或每个因素中加载最低的项目，获得了缩短的 CBRQ。缩短的 CBRQ 包含 18 个项目，这些项目具有较高的因子负荷、良好的表面效度和可靠性（Cronbach's α=0.67-0.88）。
长、短版本的 CBRQ 是测量 CFS 患者认知和行为反应的可靠和有效的量表。需要进一步研究以检验 CBRQ 在其他长期疾病中的效用。
