Zonderman A B, Heft M W, Costa P T
Health Psychol. 1985;4(5):425-36. doi: 10.1037//0278-6133.4.5.425.
Abnormal illness behavior (AIB) has been proposed as a construct measuring the inappropriate or maladaptive modes of responding to one's state of health, and the Illness Behavior Questionnaire (BQ; Pilowsky, 1975) was designed to measure this construct. Previous studies using small samples have failed to agree on the factor structure of this questionnaire. The present paper examines the factor structure of the Illness Behavior Questionnaire and critically evaluates the interpretation of its dimensions as well as the construct of AIB. A factor analysis of responses from 1,061 health care and nonhealth care seeking subjects yielded six interpretable factors which substantially replicated Pilowsky's previous results. Six scales were calculated and correlated with several personality measures. The results indicated that the Illness Behavior Questionnaire is saturated with neuroticism, a dimension known to be related to excessive medical complaints. But excessive medical complaints cannot be equated with hypochondriasis or AIB in the absence of objective medical information. In the absence of evidence for the discriminant validity of the IBQ, its use as a diagnostic device is unwarranted. Treating elevated IBQ scores as indicators of abnormal illness behavior without corroborating medical information may be more misleading than accepting patients' symptom reports at face value.
异常疾病行为（AIB）被提出作为一种衡量对自身健康状况做出不适当或适应不良反应模式的结构，疾病行为问卷（BQ；皮洛斯基，1975年）就是为测量这种结构而设计的。以往使用小样本的研究未能就该问卷的因子结构达成一致。本文研究了疾病行为问卷的因子结构，并对其维度的解释以及AIB结构进行了批判性评估。对1061名寻求医疗保健和未寻求医疗保健的受试者的回答进行因子分析，得出了六个可解释的因子，这些因子基本上重复了皮洛斯基之前的结果。计算了六个量表，并将其与几种人格测量方法进行了相关性分析。结果表明，疾病行为问卷充满了神经质，这是一个已知与过度医疗抱怨相关的维度。但在没有客观医学信息的情况下，过度医疗抱怨不能等同于疑病症或AIB。在没有证据证明IBQ具有判别效度的情况下，将其用作诊断工具是没有根据的。在没有确凿医学信息的情况下，将IBQ得分升高视为异常疾病行为的指标，可能比直接接受患者的症状报告更具误导性。
