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Psychometric properties of the Cognitive and Behavioural Responses Questionnaire (CBRQ) in adolescents with chronic fatigue syndrome

Published online by Cambridge University Press:  22 May 2019

M. E. Loades Open the ORCID record for M. E. Loades [Opens in a new window] ,
S. Vitoratou ,
K. A. Rimes ,
S. Ali  and
T. Chalder
M. E. Loades
Affiliation:
Department of Psychology, University of Bath, Bath, UK Bristol Medical School, University of Bristol, Bristol, UK
S. Vitoratou
Affiliation:
Psychometrics & Measurement Lab, Department of Biostatistics and Health Informatics, King’s College London, London, UK
K. A. Rimes
Affiliation:
King’s College London, London, UK
S. Ali
Affiliation:
South London and Maudsley NHS Trust, Beckenham, UK
T. Chalder*
Affiliation:
King’s College London, London, UK South London and Maudsley NHS Trust, Beckenham, UK
*
*Corresponding author. Email trudie.chalder@kcl.ac.uk
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Abstract

Background:

To better understand the maintenance of chronic fatigue syndrome (CFS), a valid and reliable measure of cognitive and behavioural responses to symptoms is required. Such a measure could also assess beliefs and coping behaviours in the context of fatigue in other somatic conditions.

Aims:

We aimed to establish the psychometric properties of both the Cognitive and Behavioural Responses Questionnaire (CBRQ) and its shortened version (CBRQ-S) in adolescents with CFS.

Method:

The full questionnaire was completed by a clinical cohort of adolescents (n = 121) presenting to specialist CFS units in the UK.

Results:

Both the CBRQ and CBRQ-S had good internal consistency. The CBRQ scores were strongly associated with depression, anxiety, school and social functioning, but weakly associated with fatigue and physical functioning, providing evidence of validity.

Conclusion:

Both the 40-item and the 18-item versions of the CBRQ were found to be reliable and valid in adolescents with CFS. To minimize unnecessary burden, the 18-item version is favoured. Using this assessment tool in future studies, including intervention studies, may help to better target interventions during clinical practice and improve outcomes.

Keywords

adolescentsbehaviouralCFScognitivepsychometric

Information

Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 2 , March 2020 , pp. 160 - 171
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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References

Brigden, A., Beasant, L., Hollingworth, W., Metcalfe, C., Gaunt, D., Mills, N., … & Crawley, E. (2016). Managed Activity Graded Exercise iN Teenagers and pre-Adolescents (MAGENTA) feasibility randomised controlled trial: study protocol. BMJ Open, 6, e011255. doi: 10.1136/bmjopen-2016-011255 CrossRefGoogle ScholarPubMed
Brigden, A., Loades, M., Abbott, A., Bond-Kendall, J., & Crawley, E. (2017). Practical management of chronic fatigue syndrome or myalgic encephalomyelitis in childhood. Archives of Disease in Childhood, 102, 981–986.CrossRefGoogle ScholarPubMed
Browne, T., & Chalder, T. (2006). Chronic fatigue syndrome. Psychiatry, 5, 48–51. doi: 10.1383/psyt.2006.5.2.48 CrossRefGoogle Scholar
Butler, S., Chalder, T., Ron, M., & Wessely, S. (1991). Cognitive behaviour therapy in chronic fatigue syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 54, 153–158.CrossRefGoogle ScholarPubMed
Cella, M., White, P., Sharpe, M., & Chalder, T. (2013). Cognitions, behaviours and co-morbid psychiatric diagnoses in patients with chronic fatigue syndrome. Psychological Medicine, 43, 375–380.CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Chalder, T., Deary, V., Husain, K., & Walwyn, R. (2010). Family-focused cognitive behaviour therapy versus psycho-education for chronic fatigue syndrome in 11- to 18-year-olds: a randomized controlled treatment trial. Psychological Medicine, 40, 1269–1279. doi: 10.1017/S003329170999153X CrossRefGoogle ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Crawley, E. (2014). The epidemiology of chronic fatigue syndrome/myalgic encephalitis in children. Archives of Disease in Childhood, 99, 171–174. doi: 10.1136/archdischild-2012-302156 CrossRefGoogle ScholarPubMed
Crawley, E., & Sterne, J. A. (2009). Association between school absence and physical function in paediatric chronic fatigue syndrome/myalgic encephalopathy. Archives of Disease in Childhood, 94, 752–756. doi: 10.1136/adc.2008.143537 CrossRefGoogle ScholarPubMed
Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.CrossRefGoogle Scholar
De Gucht, V., Garcia, F., den Engelsman, M., & Maes, S. (2017). Do changes in illness perceptions, physical activity, and behavioural regulation influence fatigue severity and health-related outcomes in CFS patients? Journal of Psychosomatic Research, 95, 55–61.CrossRefGoogle ScholarPubMed
Deale, A., Chalder, T., Marks, I., & Wessely, S. (1997). Cognitive behavior therapy for chronic fatigue syndrome: a randomized controlled trial. American Journal of Psychiatry, 154, 408–414.Google ScholarPubMed
Deale, A., Chalder, T., & Wessely, S. (1998). Illness beliefs and treatment outcome in chronic fatigue syndrome. Journal of Psychosomatic Research, 45, 77–83.CrossRefGoogle ScholarPubMed
Ebata, A. T., & Moos, R. H. (1991). Coping and adjustment in distressed and healthy adolescents. Journal of Applied Developmental Psychology, 12, 33–54.CrossRefGoogle Scholar
Garber, J., Weiss, B., & Shanley, N. (1993). Cognitions, depressive symptoms, and development in adolescents. Journal of Abnormal Psychology, 102, 47.CrossRefGoogle ScholarPubMed
Gauntlett-Gilbert, J., & Eccleston, C. (2007). Disability in adolescents with chronic pain: Patterns and predictors across different domains of functioning. Pain, 131, 132–141.CrossRefGoogle ScholarPubMed
Gray, S. E., & Rutter, D. R. (2007). Illness representations in young people with Chronic Fatigue Syndrome. Psychology and Health, 22, 159–174.CrossRefGoogle Scholar
Haines, C., Loades, M., & Davis, C. (2019). Illness perceptions in adolescents with chronic fatigue syndrome and other physical health conditions: application of the common sense model. Clinical Child Psychology and Psychiatry. doi: 10.1177/1359104519829796.CrossRefGoogle ScholarPubMed
Hareide, L., Finset, A., & Wyller, V. B. (2011). Chronic fatigue syndrome: a qualitative investigation of young patient’s beliefs and coping strategies. Disability Rehabilitation, 33, 2255–2263. doi: 10.3109/09638288.2011.568663 CrossRefGoogle ScholarPubMed
Haywood, K. L., Collin, S. M., & Crawley, E. (2014). Assessing severity of illness and outcomes of treatment in children with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME): a systematic review of patient-reported outcome measures (PROMs). Child: Care, Health and Development, 40, 806–824. doi: 10.1111/cch.12135 Google Scholar
Heins, M. J., Knoop, H., Burk, W. J., & Bleijenberg, G. (2013). The process of cognitive behaviour therapy for chronic fatigue syndrome: which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue? Journal of Psychosomatic Research, 75, 235–241. doi: 10.1016/j.jpsychores.2013.06.034 CrossRefGoogle ScholarPubMed
Jolly, J. B., & Dykman, R. A. (1994). Using self-report data to differentiate anxious and depressive symptoms in adolescents: cognitive content specificityand global distress? Cognitive Therapy and Research, 18, 25–37.CrossRefGoogle Scholar
Knoop, H., Prins, J. B., Moss-Morris, R., & Bleijenberg, G. (2010). The central role of cognitive processes in the perpetuation of chronic fatigue syndrome. Journal of Psychosomatic Research, 68, 489–494. doi: 10.1016/j.jpsychores.2010.01.022 CrossRefGoogle ScholarPubMed
Kovacs, M. (1992). Children’s Depression Inventory. North Tonawanda, NY, USA: Multi-Health Systems.Google Scholar
Lloyd, S., Chalder, T., & Rimes, K. A. (2012). Family-focused cognitive behaviour therapy versus psycho-education for adolescents with chronic fatigue syndrome: long-term follow-up of an RCT. Behaviour Research and Therapy, 50, 719–725. doi: 10.1016/j.brat.2012.08.005 CrossRefGoogle ScholarPubMed
Moss-Morris, R., & Chalder, T. (2003). Illness representations: where to from here? Paper presented at the 16th Conference of the European Health Psychology Society, Kos, Greece.Google Scholar
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. The British Journal of Psychiatry, 180, 461–464.CrossRefGoogle ScholarPubMed
NICE (2007). Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management of CFS/ME in adults and children. Available at: https://www.nice.org.uk/guidance/cg53/evidence/full-guideline-pdf-196524109 Google Scholar
Nijhof, S. L., Bleijenberg, G., Uiterwaal, C. S., Kimpen, J. L., & van de Putte, E. M. (2011). Fatigue In Teenagers on the interNET– the FITNET Trial. A randomized clinical trial of web-based cognitive behavioural therapy for adolescents with chronic fatigue syndrome: study protocol. BMC Neurology, 11, 23. doi: 10.1186/1471-2377-11-23 CrossRefGoogle Scholar
Nijhof, S. L., Bleijenberg, G., Uiterwaal, C. S., Kimpen, J. L., & van de Putte, E. M. (2012). Effectiveness of internet-based cognitive behavioural treatment for adolescents with chronic fatigue syndrome (FITNET): a randomised controlled trial. The Lancet, 379, 1412–1418.CrossRefGoogle ScholarPubMed
Parslow, R. M., Anderson, N., Byrne, D., Shaw, A., Haywood, K. L., & Crawley, E. (2018). Adolescent’s descriptions of fatigue, fluctuation and payback in chronic fatigue syndrome/myalgic encephalopathy (CFS/ME): interviews with adolescents and parents. BMJ Paediatrics Open, 2, e000281. doi: 10.1136/bmjpo-2018-000281 CrossRefGoogle ScholarPubMed
Ray, C., Weir, W., Stewart, D., Miller, P., & Hyde, G. (1993). Ways of coping with chronic fatigue syndrome: development of an illness management questionnaire. Social Science & Medicine, 37, 385–391.CrossRefGoogle ScholarPubMed
Richards, J., Turk, J., & White, S. (2005). Children and adolescents with Chronic Fatigue Syndrome in non-specialist settings: beliefs, functional impairment and psychiatric disturbance. European Child and Adolescent Psychiatry, 14, 310–318. doi: 10.1007/s00787-005-0477-4 CrossRefGoogle ScholarPubMed
Rumsey, D. J. (2015). U Can: Statistics for Dummies. Hoboken, NJ: John Wiley & Sons.Google Scholar
Ryan, E. G., Vitoratou, S., Goldsmith, K. A., & Chalder, T. (2018). Psychometric properties and factor structure of a shortened version of the Cognitive Behavioural Responses Questionnaire (CBRQ). Psychosomatic Medicine, 80, 230–237.CrossRefGoogle Scholar
Sankey, A., Hill, C. M., Brown, J., Quinn, L., & Fletcher, A. (2006). A follow-up study of chronic fatigue syndrome in children and adolescents: symptom persistence and school absenteeism. Clinical Child Psychology and Psychiatry, 11, 126–138.CrossRefGoogle ScholarPubMed
Schanberg, L. E., Kredich, D. W., Keefe, F. J., Lefebvre, J. C., & Gil, K. M. (1996). Pain coping strategies in children with juvenile primary fibromyalgia syndrome: correlation with pain, physical function, and psychological distress. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 9, 89–96.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Smith, M. S., Martin-Herz, S. P., Womack, W. M., & Marsigan, J. L. (2003). Comparative study of anxiety, depression, somatization, functional disability, and illness attribution in adolescents with chronic fatigue or migraine. Pediatrics, 111, e376–381.CrossRefGoogle ScholarPubMed
Spielberger, C. D. (1983). Manual for the State-Trait Anxiety Inventory STAI (form Y) (‘self-evaluation questionnaire’).CrossRefGoogle Scholar
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.CrossRefGoogle Scholar
Stulemeijer, M., de Jong, L. W., Fiselier, T. J., Hoogveld, S. W., & Bleijenberg, G. (2005). Cognitive behaviour therapy for adolescents with chronic fatigue syndrome: randomised controlled trial. British Medical Journal, 330, 14. doi: 10.1136/bmj.38301.587106.63 CrossRefGoogle ScholarPubMed
Surawy, C., Hackmann, A., Hawton, K., & Sharpe, M. (1995). Chronic Fatigue Syndrome: a cognitive approach. Behaviour Research and Therapy, 33, 535–544. doi: 10.1016/0005-7967(94)00077-W CrossRefGoogle ScholarPubMed
Taylor, A. K., Loades, M., Brigden, A. L., Collin, S. M., & Crawley, E. (2017). ‘It’s personal to me’: a qualitative study of depression in young people with CFS/ME. Clinical Child Psychology and Psychiatry, 22, 326–340.CrossRefGoogle ScholarPubMed
Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30, 473–483.CrossRefGoogle ScholarPubMed
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 and Health, 11, 431–445.CrossRefGoogle Scholar
Wessely, S., Butler, S., Chalder, T., & David, A. (1991). The cognitive behavioural management of the post-viral fatigue syndrome. In Post-Viral Fatigue Syndrome (pp. 305–334). Chichester, UK: John Wiley & Sons Ltd.Google Scholar
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