The Cognitive and Behavioural Responses to Symptoms Questionnaire (CBRQ): Development, reliability and validity across several long‐term conditions

• Published in: British journal of health psychology 2023-05, Vol.28 (2), p.619-638
• Main Authors: Picariello, Federica, Chilcot, Joseph, Chalder, Trudie, Herdman, David, Moss‐Morris, Rona
• Format: Article
• Language: English
• Subjects: Avoidance behavior; Behavioral responses; CBRQ; Change agents; Chronic fatigue syndrome; Cognition; cognitive; Cognitive-behavioral factors; Confirmatory factor analysis; Construct validity; Dialysis; Dizziness; Embarrassment; factor analysis; Fear; Humans; Multiple sclerosis; Psychometrics; Quantitative psychology; Questionnaires; Reliability; Reproducibility of Results; Resting; Surveys and Questionnaires; Symptoms; transdiagnostic; Validation studies; Validity
• ISSN: 1359-107X; 2044-8287
• DOI: 10.1111/bjhp.12644

Objectives 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. Design Psychometric validation study. Methods 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. Results 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. Conclusions 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.