Rosebrock Laina, Lambe Sinéad, Mulhall Sophie, Petit Ariane, Loe Bao S, Saidel Simone, Pervez Maryam, Mitchell Joanna, Chauhan Nisha, Prouten Eloise, Chan Cindy, Aynsworth Charlotte, Murphy Elizabeth, Jones Julia, Powling Rosie, Chapman Kate, Dudley Robert, Morrison Anthony, O'Regan Eileen, Clark David M, Waite Felicity, Freeman Daniel
Department of Psychiatry, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
Behav Cogn Psychother. 2022 Feb 15;50(3):1-12. doi: 10.1017/S1352465822000030.
Many patients with mental health disorders become increasingly isolated at home due to anxiety about going outside. A cognitive perspective on this difficulty is that threat cognitions lead to the safety-seeking behavioural response of agoraphobic avoidance.
We sought to develop a brief questionnaire, suitable for research and clinical practice, to assess a wide range of cognitions likely to lead to agoraphobic avoidance. We also included two additional subscales assessing two types of safety-seeking defensive responses: anxious avoidance and within-situation safety behaviours.
198 patients with psychosis and agoraphobic avoidance and 1947 non-clinical individuals completed the item pool and measures of agoraphobic avoidance, generalised anxiety, social anxiety, depression and paranoia. Factor analyses were used to derive the Oxford Cognitions and Defences Questionnaire (O-CDQ).
The O-CDQ consists of three subscales: threat cognitions (14 items), anxious avoidance (11 items), and within-situation safety behaviours (8 items). Separate confirmatory factor analyses demonstrated a good model fit for all subscales. The cognitions subscale was significantly associated with agoraphobic avoidance (r = .672, p < .001), social anxiety (r = .617, p < .001), generalized anxiety (r = .746, p < .001), depression (r = .619, p < .001) and paranoia (r = .655, p < .001). Additionally, both the O-CDQ avoidance (r = .867, p < .001) and within-situation safety behaviours (r = .757, p < .001) subscales were highly correlated with agoraphobic avoidance. The O-CDQ demonstrated excellent internal consistency (cognitions Cronbach's alpha = .93, avoidance Cronbach's alpha = .94, within-situation Cronbach's alpha = .93) and test-re-test reliability (cognitions ICC = 0.88, avoidance ICC = 0.92, within-situation ICC = 0.89).
The O-CDQ, consisting of three separate scales, has excellent psychometric properties and may prove a helpful tool for understanding agoraphobic avoidance across mental health disorders.
许多患有精神健康障碍的患者因担心外出而越来越多地在家中独处。从认知角度来看，这种困难在于威胁认知会导致广场恐惧症回避的安全寻求行为反应。
我们试图开发一份简短的问卷，适用于研究和临床实践，以评估一系列可能导致广场恐惧症回避的认知。我们还纳入了另外两个子量表，用于评估两种类型的安全寻求防御反应：焦虑回避和情境内安全行为。
198名患有精神病和广场恐惧症回避的患者以及1947名非临床个体完成了项目库以及广场恐惧症回避、广泛性焦虑、社交焦虑、抑郁和偏执的测量。采用因素分析得出牛津认知与防御问卷（O-CDQ）。
O-CDQ由三个子量表组成：威胁认知（14个项目）、焦虑回避（11个项目）和情境内安全行为（8个项目）。单独的验证性因素分析表明所有子量表的模型拟合良好。认知子量表与广场恐惧症回避（r = 0.672，p < 0.001）、社交焦虑（r = 0.617，p < 0.001）、广泛性焦虑（r = 0.746，p < 0.001）、抑郁（r = 0.619，p < 0.001）和偏执（r = 0.655，p < 0.001）显著相关。此外，O-CDQ回避子量表（r = 0.867，p < 0.001）和情境内安全行为子量表（r = 0.757，p < 0.001）均与广场恐惧症回避高度相关。O-CDQ表现出出色的内部一致性（认知方面的克朗巴赫α系数 = 0.93，回避方面的克朗巴赫α系数 = 0.94，情境内方面的克朗巴赫α系数 = 0.93）和重测信度（认知方面的组内相关系数ICC = 0.88，回避方面的ICC = 0.92，情境内方面的ICC = 0.89）。
由三个独立量表组成的O-CDQ具有出色的心理测量特性，可能是理解各类精神健康障碍中广场恐惧症回避的有用工具。
