The Cognitive and Behavioural Responses to Symptoms Questionnaire (CBRQ): Development, reliability and validity across several long-term conditions.
CBRQ
cognitive
factor analysis
psychometrics
reliability
symptoms
transdiagnostic
validity
Journal
British journal of health psychology
ISSN: 2044-8287
Titre abrégé: Br J Health Psychol
Pays: England
ID NLM: 9605409
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
revised:
07
12
2022
received:
21
09
2022
accepted:
06
01
2023
medline:
11
4
2023
pubmed:
24
1
2023
entrez:
23
1
2023
Statut:
ppublish
Résumé
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.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
619-638Informations de copyright
© 2023 The British Psychological Society.
Références
Ali, S., Matcham, F., Irving, K., & Chalder, T. (2017). Fatigue and psychosocial variables in autoimmune rheumatic disease and chronic fatigue syndrome: A cross-sectional comparison. Journal of Psychosomatic Research, 92, 1-8.
Artom, M., Czuber-Dochan, W., Sturt, J., Murrells, T., & Norton, C. (2017). The contribution of clinical and psychosocial factors to fatigue in 182 patients with inflammatory bowel disease: A cross-sectional study. Alimentary Pharmacology & Therapeutics, 45, 403-416.
Asmundson, G. J., Norton, P. J., & Vlaeyen, J. W. (2004). Fear-avoidance models of chronic pain: An overview. In G. J. Asmundson, J. W. S. Vlaeyen, & G. Crombez (Eds.), Understanding and treating fear of pain (pp. 3-24). Oxford University Press.
Barends, H., Claassen-van Dessel, N., van der Wouden, J. C., Twisk, J. W., Terluin, B., van der Horst, H. E., & Dekker, J. (2020). Impact of symptom focusing and somatosensory amplification on persistent physical symptoms: A three-year follow-up study. Journal of Psychosomatic Research, 135, 110131.
Beauducel, A., & Herzberg, P. Y. (2006). On the performance of maximum likelihood versus means and variance adjusted weighted least squares estimation in CFA. Structural Equation Modeling, 13, 186-203.
Bentler, P. M. (1990). Comparative fit indexes in structural models. Psychological Bulletin, 107, 238-246.
Burns, J. W., Day, M. A., & Thorn, B. E. (2012). Is reduction in pain catastrophizing a therapeutic mechanism specific to cognitive-behavioral therapy for chronic pain? Translational Behavioral Medicine, 2, 22-29.
Cella, M., Chalder, T., & White, P. (2011). Does the heterogeneity of chronic fatigue syndrome moderate the response to cognitive behaviour therapy? An exploratory study. Psychotherapy and Psychosomatics, 80, 353-358.
Chalder, T., Berelowitz, G., Pawlikowska, T., Watts, L., Wessely, S., Wright, D., & Wallace, E. (1993). Development of a fatigue scale. Journal of Psychosomatic Research, 37, 147-153.
Chalder, T., Goldsmith, K. A., White, P. D., Sharpe, M., & Pickles, A. R. (2015). Rehabilitative therapies for chronic fatigue syndrome: A secondary mediation analysis of the PACE trial. The Lancet Psychiatry, 2, 141-152.
Chilcot, J., & Moss-Morris, R. (2013). Changes in illness-related cognitions rather than distress mediate improvements in irritable bowel syndrome (IBS) symptoms and disability following a brief cognitive behavioural therapy intervention. Behaviour Research and Therapy, 51, 690-695.
Chilcot, J., Moss-Morris, R., Artom, M., Harden, L., Picariello, F., Hughes, H., Bates, S., & Macdougall, I. C. (2016). Psychosocial and clinical correlates of fatigue in haemodialysis patients: The importance of patients' illness cognitions and behaviours. International Journal of Behavioral Medicine, 23, 271-281.
Cleeland, C. S. (2007). Symptom burden: Multiple symptoms and their impact as patient-reported outcomes. Journal of the National Cancer Institute Monographs, 2007, 16-21.
Crombez, G., De Paepe, A. L., Veirman, E., Eccleston, C., Verleysen, G., & Van Ryckeghem, D. M. (2020). Let's talk about pain catastrophizing measures: An item content analysis. PeerJ, 8, e8643.
Crowe, M., Whitehead, L., Seaton, P., Jordan, J., Mccall, C., Maskill, V., & Trip, H. (2017). Qualitative meta-synthesis: The experience of chronic pain across conditions. Journal of Advanced Nursing, 73, 1004-1016.
Department of Health. (2012). Long term conditions compendium of information (3rd ed.). Department of Health.
Dixon, D., & Johnston, M. (2019). Content validity of measures of theoretical constructs in health psychology: Discriminant content validity is needed. British Journal of Health Psychology, 24, 477-484.
Dunn, T. J., Baguley, T., & Brunsden, V. (2014). From alpha to omega: A practical solution to the pervasive problem of internal consistency estimation. British Journal of Psychology, 105, 399-412.
Eckerblad, J., Theander, K., Ekdahl, A., Unosson, M., Wirehn, A.-B., Milberg, A., Krevers, B., & Jaarsma, T. (2015). Symptom burden in community-dwelling older people with multimorbidity: A cross-sectional study. BMC Geriatrics, 15, 1-9.
Finney, S. J., & DiStefano, C. (2006). Chapter 9: Non-normal and categorical data in structural equation modeling. In G. R. Hancock & R. O. Mueller (Eds.), Structural equation modeling: A second course (pp. 269-314). IAP - Information Age Publishing.
Flora, D. B., & Curran, P. J. (2004). An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychological Methods, 9, 466-491.
Gagnier, J. J., Lai, J., Mokkink, L. B., & Terwee, C. B. (2021). COSMIN reporting guideline for studies on measurement properties of patient-reported outcome measures. Quality of Life Research, 30, 2197-2218.
Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60, 549-576.
Hagger, M. S., Koch, S., Chatzisarantis, N. L., & Orbell, S. (2017). The common sense model of self-regulation: Meta-analysis and test of a process model. Psychological Bulletin, 143, 1117-1154.
Harrison, A. M., Bogosian, A., Silber, E., McCracken, L. M., & Moss-Morris, R. (2015). ‘It feels like someone is hammering my feet’: Understanding pain and its management from the perspective of people with multiple sclerosis. Multiple Sclerosis Journal, 21, 466-476.
Herdman, D., Norton, S., Pavlou, M., Murdin, L., & Moss-Morris, R. (2020a). The role of prediagnosis audiovestibular dysfunction versus distress, illness-related cognitions, and behaviors in predicted ongoing dizziness handicap. Psychosomatic Medicine, 82, 787-795.
Herdman, D., Norton, S., Pavlou, M., Murdin, L., & Moss-Morris, R. (2020b). Vestibular deficits and psychological factors correlating to dizziness handicap and symptom severity. Journal of Psychosomatic Research, 132, 109969.
Hewlett, S., Cockshott, Z., Byron, M., Kitchen, K., Tipler, S., Pope, D., & Hehir, M. (2005). Patients' perceptions of fatigue in rheumatoid arthritis: Overwhelming, uncontrollable, ignored. Arthritis Care & Research, 53, 697-702.
Hoelter, J. W. (1983). The analysis of covariance structures: Goodness-of-fit indices. Sociological Methods & Research, 11, 325-344.
Howard, M. C. (2016). A review of exploratory factor analysis decisions and overview of current practices: What we are doing and how can we improve? International Journal of Human-Computer Interaction, 32, 51-62.
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1-55.
Jacobsen, P., Azzarello, L., & Hann, D. (1999). Relation of catastrophizing to fatigue severity in women with breast cancer. Cancer Research, Therapy, and Control, 8, 1999-1164.
Jacobson, G. P., & Newman, C. W. (1990). The development of the dizziness handicap inventory. Archives of Otolaryngology-Head and Neck Surgery, 116, 424-427.
Jensen, M. P., Moore, M. R., Bockow, T. B., Ehde, D. M., & Engel, J. M. (2011). Psychosocial factors and adjustment to chronic pain in persons with physical disabilities: A systematic review. Archives of Physical Medicine and Rehabilitation, 92, 146-160.
Katon, W., Lin, E. H., & Kroenke, K. (2007). The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. General Hospital Psychiatry, 29, 147-155.
Kline, R. (2005). Principles and practice of structural equation modeling (2nd ed.). New York, NY.
Knoop, H., van Kessel, K., & Moss-Morris, R. (2012). Which cognitions and behaviours mediate the positive effect of cognitive behavioural therapy on fatigue in patients with multiple sclerosis? Psychological Medicine, 42, 205-213.
Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32, 509-515.
Leeuw, M., Goossens, M. E. J. B., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. S. (2007). The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence. Journal of Behavioral Medicine, 30, 77-94.
Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Leventhal, E. A., Patrick-Miller, L., & Robitaille, C. (1997). Illness representations: Theoretical foundations. Perceptions of Health and Illness, 2, 19-46.
Leventhal, H., Leventhal, E. A., & Contrada, R. J. (1998). Self-regulation, health, and behavior: A perceptual-cognitive approach. Psychology & Health, 13, 717-733.
Leventhal, H., Nerenz, D. R., & Purse, J. (1984). Illness representations and coping with health threats. In A. Baum, S. E. Taylor, & J. E. Singer (Eds.), Handbook of psychology and health (pp. 219-252). Lawrence Erlbaum Associates, Inc.
Loades, M., Vitoratou, S., Rimes, K., Ali, S., & Chalder, T. (2020). Psychometric properties of the cognitive and Behavioural responses questionnaire (CBRQ) in adolescents with chronic fatigue syndrome. Behavioural and Cognitive Psychotherapy, 48, 160-171.
Lukkahatai, N., & Saligan, L. N. (2013). Association of catastrophizing and fatigue: A systematic review. Journal of Psychosomatic Research, 74, 100-109.
Mokkink, L. B., Terwee, C. B., Patrick, D. L., Alonso, J., Stratford, P. W., Knol, D. L., Bouter, L. M., & de Vet, H. C. (2010). The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. Journal of Clinical Epidemiology, 63, 737-745.
Moss-Morris, R. (2005). Symptom perceptions, illness beliefs and coping in chronic fatigue syndrome. Journal of Mental Health, 14, 223-235.
Moss-Morris, R., & Chalder, T. (2003). Illness representations: Where to from here? In 16th Conference of the European Health Psychology Society; Kos, Greece.
Moss-Morris, R., McAlpine, L., Didsbury, L., & Spence, M. (2010). A randomized controlled trial of a cognitive behavioural therapy-based self-management intervention for irritable bowel syndrome in primary care. Psychological Medicine, 40, 85-94.
Moss-Morris, R., Sharon, C., Tobin, R., & Baldi, J. C. (2005). A randomized controlled graded exercise trial for chronic fatigue syndrome: Outcomes and mechanisms of change. Journal of Health Psychology, 10, 245-259.
Moss-Morris, R., Weinman, J., Petrie, K., Horne, R., Cameron, L., & Buick, D. (2002). The revised illness perception questionnaire (IPQ-R). Psychology & Health, 17, 1-16.
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. H. (2002). The work and social adjustment scale: A simple measure of impairment in functioning. British Journal of Psychiatry, 180, 461-464.
Muthén, L. K., & Muthén, B. O. (2017). Mplus user's guide (8th ed.). Muthén & Muthén.
NHS Digital. (2018). Health Survey for England 2018.
Patrick, D. L., Burke, L. B., Gwaltney, C. J., Leidy, N. K., Martin, M. L., Molsen, E., & Ring, L. (2011). Content validity-Establishing and reporting the evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO good research practices task force report: Part 2-Assessing respondent understanding. Value in Health, 14, 978-988.
Picariello, F., Moss-Morris, R., Macdougall, I. C., & Chilcot, J. (2016). Measuring fatigue in haemodialysis patients: The factor structure of the Chalder fatigue questionnaire (CFQ). Journal of Psychosomatic Research, 84, 81-83.
Picariello, F., Moss-Morris, R., Macdougall, I. C., & Chilcot, J. (2017). “It's when you're not doing too much you feel tired”: A qualitative exploration of fatigue in end-stage kidney disease (ESKD). British Journal of Health Psychology, 23, 311-333.
Picariello, F., Norton, S., Moss-Morris, R., Macdougall, I. C., & Chilcot, J. (2018). Fatigue in prevalent haemodialysis patients predicts all-cause mortality and kidney transplantation. Annals of Behavioral Medicine, 53, 501-514.
Picariello, F., Norton, S., Moss-Morris, R., Macdougall, I. C., & Chilcot, J. (2020). A prospective study of fatigue among in-centre haemodialysis patients. British Journal of Health Psychology, 25, 61-88.
Quartana, P. J., Campbell, C. M., & Edwards, R. R. (2009). Pain catastrophizing: A critical review. Expert Review of Neurotherapeutics, 9, 745-758.
Ryan, E. G., Vitoratou, S., Goldsmith, K. A., & Chalder, T. (2018). Psychometric properties and factor structure of a long and shortened version of the cognitive and behavioural responses questionnaire. Psychosomatic Medicine, 80, 230-237.
Sarter, L., Heider, J., Kirchner, L., Schenkel, S., Witthöft, M., Rief, W., & Kleinstäuber, M. (2021). Cognitive and emotional variables predicting treatment outcome of cognitive behavior therapies for patients with medically unexplained symptoms: A meta-analysis. Journal of Psychosomatic Research, 146, 110486.
Scott, J. A., Lasch, K. E., Barsevick, A. M., & Piault-Louis, E. (2011). Patients' experiences with cancer-related fatigue: A review and synthesis of qualitative research. Oncology Nursing Forum, 38, E191-E203.
Skerrett, T. N., & Moss-Morris, R. (2006). Fatigue and social impairment in multiple sclerosis: The role of patients' cognitive and behavioral responses to their symptoms. Journal of Psychosomatic Research, 61, 587-593.
Smets, E., Garssen, B., Bonke, B. d., & De Haes, J. (1995). The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue. Journal of Psychosomatic Research, 39, 315-325.
Solano, J. P., Gomes, B., & Higginson, I. J. (2006). A comparison of symptom prevalence in far advanced cancer, AIDS, heart disease, chronic obstructive pulmonary disease and renal disease. Journal of Pain and Symptom Management, 31, 58-69.
Spence, M., Moss-Morris, R., & Chalder, T. (2005). The Behavioural responses to illness questionnaire (BRIQ): A new predictive measure of medically unexplained symptoms following acute infection. Psychological Medicine, 35, 583-593.
Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166, 1092-1097.
Stahl, D., Rimes, K., & Chalder, T. (2014). Mechanisms of change underlying the efficacy of cognitive behaviour therapy for chronic fatigue syndrome in a specialist clinic: A mediation analysis. Psychological Medicine, 44, 1331-1344.
Steiger, J. H. (1990). Structural model evaluation and modification: An interval estimation approach. Multivariate Behavioral Research, 25, 173-180.
Sullivan, M. J., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: Development and validation. Psychological Assessment, 7, 524-532.
Taylor, E. C., O'Neill, M., Hughes, L. D., Carroll, S., & Moss-Morris, R. (2018). ‘It's like a frog leaping about in your chest’: Illness and treatment perceptions in persistent atrial fibrillation. British Journal of Health Psychology, 23, 3-21.
Trizano-Hermosilla, I., & Alvarado, J. M. (2016). Best alternatives to Cronbach's alpha reliability in realistic conditions: Congeneric and asymmetrical measurements. Frontiers in Psychology, 7, 769.
Tucker, L. R., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38, 1-10.
van Kessel, K., Moss-Morris, R., Willoughby, E., Chalder, T., Johnson, M. H., & Robinson, E. (2008). A randomized controlled trial of cognitive behavior therapy for multiple sclerosis fatigue. Psychosomatic Medicine, 70, 205-213.
Weinman, J., Petrie, K. J., Moss-Morris, R., & Horne, R. (1996). The illness perception questionnaire: A new method for assessing the cognitive representation of illness. Psychology & Health, 11, 431-445.
Wertli, M. M., Rasmussen-Barr, E., Held, U., Weiser, S., Bachmann, L. M., & Brunner, F. (2014). Fear-avoidance beliefs-A moderator of treatment efficacy in patients with low back pain: A systematic review. The Spine Journal, 14, 2658-2678.
Whitehead, L. C., Unahi, K., Burrell, B., & Crowe, M. T. (2016). The experience of fatigue across long-term conditions: A qualitative meta-synthesis. Journal of Pain and Symptom Management, 52, 131-143.
Willadsen, T. G., Siersma, V., Nicolaisdottir, D. R., Jarbol, D., Guassora, A. D., Reventlow, S., & Køster-Rasmussen, R. (2021). Symptom burden in multimorbidity: A population-based combined questionnaire and registry study from Denmark. BMJ Open, 11, e041877.
Windgassen, S., Moss-Morris, R., Chilcot, J., Sibelli, A., Goldsmith, K., & Chalder, T. (2017). The journey between brain and gut: A systematic review of psychological mechanisms of treatment effect in irritable bowel syndrome. British Journal of Health Psychology, 22, 701-736.
Windgassen, S., Moss-Morris, R., Goldsmith, K., & Chalder, T. (2019). Key mechanisms of cognitive behavioural therapy in irritable bowel syndrome: The importance of gastrointestinal related cognitions, behaviours and general anxiety. Journal of Psychosomatic Research, 118, 73-82.
Yardley, L., Burgneay, J., Andersson, G., Owen, N., Nazareth, I., & Luxon, L. (1998). Feasibility and effectiveness of providing vestibular rehabilitation for dizzy patients in the community. Clinical Otolaryngology & Allied Sciences, 23, 442-448.
Yardley, L., Masson, E., Verschuur, C., Haacke, N., & Luxon, L. (1992). Symptoms, anxiety and handicap in dizzy patients: Development of the vertigo symptom scale. Journal of Psychosomatic Research, 36, 731-741.
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361-370.
Zinbarg, R. E., Revelle, W., Yovel, I., & Li, W. (2005). Cronbach's α, Revelle's β, and McDonald's ω H: Their relations with each other and two alternative conceptualizations of reliability. Psychometrika, 70, 123-133.