Picariello Federica, Chilcot Joseph, Chalder Trudie, Herdman David, Moss-Morris Rona
Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK.
Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK.
Br J Health Psychol. 2023 May;28(2):619-638. doi: 10.1111/bjhp.12644. Epub 2023 Jan 23.
Cognitive and behavioural responses to symptoms can worsen or maintain the severity of symptoms across long-term conditions (LTCs). Although the Cognitive and Behavioural Responses Questionnaire (CBRQ) has been used in research, its original development and psychometric properties as a transdiagnostic measure have not been reported. Our aim was to evaluate the psychometric properties of the CBRQ and a recently proposed short version, across different LTCs.
Psychometric validation study.
Confirmatory factor analysis (CFA) tested the factor structure of the CBRQ in two datasets from the CBRQ's original development; (chronic fatigue syndrome, N = 230; and multiple sclerosis, N = 221) and in additional groups: haemodialysis (N = 174), inflammatory bowel disease (N = 182) and chronic dizziness (N = 185). Scale reliability and construct validity were assessed. The factor structure of the shortened CBRQ (CBRQ-SF) was also assessed.
CFA revealed that a 7-or 8-factor structure had generally appropriate fit supporting the originally proposed 7 factors (Fear avoidance, Damage beliefs, Catastrophising, Embarrassment avoidance, Symptom focusing, All-or-nothing behaviour and Avoidance/Resting behaviour). Omega coefficients indicated satisfactory internal reliability. Correlations with related constructs suggested construct validity. The scale appeared sensitive to change. The CBRQ-SF also displayed good psychometric quality, with a better model fit than the CBRQ.
The CBRQ and the shortened version were shown to be reliable and valid at assessing a range of cognitive and behavioural responses to symptoms, highlighting the multi-symptom, transdiagnostic properties of this questionnaire. Further research is necessary to determine the test-retest reliability and sensitivity to change of the CBRQ and CBRQ-SF and a thorough evaluation of the content validity of the items.
对症状的认知和行为反应会加重或维持长期病症（LTC）的症状严重程度。尽管认知与行为反应问卷（CBRQ）已用于研究，但其作为一种跨诊断测量工具的原始开发及心理测量特性尚未见报道。我们的目的是评估CBRQ及其最近提出的简短版本在不同LTC中的心理测量特性。
心理测量验证研究。
验证性因素分析（CFA）在CBRQ原始开发的两个数据集中测试其因素结构；（慢性疲劳综合征，N = 230；多发性硬化症，N = 221）以及其他群体：血液透析（N = 174）、炎症性肠病（N = 182）和慢性头晕（N = 185）。评估量表的信度和结构效度。还评估了简短版CBRQ（CBRQ-SF）的因素结构。
CFA显示，7因素或8因素结构总体拟合良好，支持最初提出的7个因素（恐惧回避、损害信念、灾难化、尴尬回避、症状聚焦、全或无行为以及回避/休息行为）。欧米茄系数表明内部信度令人满意。与相关结构的相关性表明具有结构效度。该量表似乎对变化敏感。CBRQ-SF也显示出良好的心理测量质量，其模型拟合优于CBRQ。
CBRQ及其简短版本在评估一系列对症状的认知和行为反应方面被证明是可靠且有效的，突出了该问卷的多症状、跨诊断特性。有必要进一步研究以确定CBRQ和CBRQ-SF的重测信度和对变化的敏感性，并对项目的内容效度进行全面评估。
