The illness perception questionnaire: A new method for assessing the cognitive representation of illness

Abstract

The Illness Perception Questionnaire (IPQ) is a new method for assessing cognitive representations of illness. The IPQ is a theoretically derived measure comprising five scales that provides information about the five components that have been found to underlie the cognitive representation of illness. The five scales assess identity - the symptoms the patient associates with the illness, cause - personal ideas about aetiology, time-line - the perceived duration of the illness, consequences - expected effects and outcome and cure control - how one controls or recovers from the illness. The IPQ has a specific number of core items but allows the user to add items for particular patient groups or health threats. Data is presented supporting the reliability and validity of the IPQ scales in different chronic illness populations.     

Dilemmas in qualitative health research

Abstract

As the use of qualitative methods in health research proliferates, it becomes increasingly necessary to consider how the value of a piece of qualitative research should be assessed. This article discusses the problem posed by the novelty and diversity of qualitative approaches within health psychology and considers the question of what criteria are appropriate for assessing the validity of a qualitative analysis. In keeping with the ethos of much qualitative research, some open-ended, flexible principles are suggested as a guide to the quality of a qualitative study: sensitivity to context; commitment and rigour; transparency and coherence; impact and importance. Examples are given of the very different ways in which various forms of qualitative research can meet these criteria.     

Habitual Self‐Control: A Brief Measure of Persistent Goal Pursuit

Habitual self‐control is defined as a trait‐like personal resource factor that facilitates the enactment of difficult intentions. A 14‐item Habitual Self‐Control Questionnaire (HSCQ) was developed to assess this trait. Reliability, factorial validity, and criterion validity were assessed in five undergraduate student subsamples with an overall N of 2224. Internal consistency was .81 across the entire sample, and test–retest reliability was .83 over a one‐month interval. The HSCQ showed a theoretically meaningful pattern in terms of convergent and discriminant validity and criterion validity in predicting a variety of health behaviours that relate to self‐control, including exercise, dieting behaviour, binge eating and weight loss success. Further, the HSCQ contributed uniquely to the prediction of health behaviours beyond alternative self‐control scales. In a longitudinal part of the study, the HSCQ added to the prediction of action plan completion and satisfaction beyond motivation and moderated the relationship between motivation and enactment of action plans as theoretically expected. In sum, the results provided strong evidence for the reliability and validity of the HSCQ and highlighted some theoretically meaningful differences to already existing measures of self‐control. Theoretical implications are discussed. Copyright © 2012 John Wiley & Sons, Ltd.     

Detecting performance invalidity in children: Not quite as easy as A,B, C, 1, 2, 3 but automatized sequences appears promising

In adult populations, embedded performance validity indicators are well established, as they are time efficient, resistant to coaching, and allow for more continuous monitoring of effort than standalone measures. Although several recent studies have demonstrated the appropriateness of using standalone validity tests with school-age children, a paucity of pediatric work has examined embedded indicators. The present study investigated the value of a simple automatized sequences task to detect performance invalidity in 439 clinically referred patients with mild head injury aged 8 through 17 years. Sixteen percent of the participants failed the Medical Symptom Validity Test (MSVT). Thirteen percent failed the MSVT and also performed below established cutoffs on either the Test of Memory Malingering or Wechsler Digit Span subtest. The group classified as providing invalid data performed significantly worse than the group passing the MSVT across all sequencing conditions. Sensitivity and specificity for the total time on the sequencing task compared favorably to data produced for many respected adult-based embedded indicators (i.e., sensitivity around 50% when specificity ≥ 90%). Classification statistics for any embedded performance validity test can be expected to be worse in more severely affected populations; however, the current sequencing task appears to have value in detecting invalid performance in relatively high-functioning older children and adolescents. The fact that the task takes less than a couple of minutes to administer makes it especially appealing.     

Suitability Screening During Basic Military Training

Results are presented for suitability screening conducted by the United States Air Force during basic military training. The Lackland Behavioral Questionnaire has been used operationally since 2007, and its use has led to an increase in predictive validity. For the prediction of outcomes during the first 4 years of service, one can identify trainees with a 49% likelihood of being separated for unsuitability and a 56% likelihood of being diagnosed with a mental disorder. A formal suitability screening program allows referrals and recommendations to be made using a combination of empirical evidence and clinical judgment.     

Noncredible Effort during Pediatric Neuropsychological Exam: A Case Series and Literature Review

Neuropsychological test interpretation rests upon the assumption that the examinee has exerted full effort. If an individual provides inadequate effort during exam, the resulting data will be invalid and represent an underestimate of the person's true abilities. Although youth have been assumed historically to be less capable of deception than adults, acts of deception in childhood are not uncommon, even in normative populations. Yet, very few cases of children who have provided suboptimal effort during neuropsychological exam have appeared in the scientific literature. We present six clinical cases illustrating that children down to at least age 8 years can present with noncredible performance. The cases include those in which clear external incentives could be identified to those in which intrinsic or psychological factors were presumed to predominate. The fairly diverse nature of the presented cases, along with other recent work, suggests that suboptimal effort in children is apt to occur more frequently than previously recognized, even if it might occur less often than in comparable adult samples. In most of the presented cases, noncredible performance would not have been detected definitively by clinical judgment alone, reinforcing the value of routinely incorporating symptom validity tests into the neuropsychological assessment of school-aged children. The number of effort tests that have demonstrated utility in children pales in comparison to those available to the adult practitioner, although recent research now supports the use of several standalone measures with pediatric patients.     

Organisation of executive functions: Hemispheric asymmetries

This address provides a review of evidence for a deconstruction of executive functions, the set of cognitive operations which allow goal-directed behaviour. The underlying working hypothesis is that some complementary and computationally diverse executive functions are dissociable not only functionally but also temporally and anatomically, along the left-right axis of prefrontal cortex and related neural networks. In particular, criterion setting—the capacity to flexibly set up and select task rules—is more left-lateralised; monitoring—the process of continuously evaluating the internal or external contingencies to optimise behaviour—is more right-lateralised; finally, superior medial prefrontal regions, including dorsal anterior cingulate cortex, play a role in energising weakly activated but relevant processes. Several lines of empirical evidence, including neuroimaging and neuropsychological findings, are presented to support this tripartite model of executive functions. Evidence which is difficult to explain with this model and some future directions are also discussed.     

A concise review of the correspondence between the traditional functional analysis and alternative assessment formats

The functional assessment of challenging behavior (e.g., self-injurious behavior) has evolved over many years of research and practice. This concise review summarizes the positive predictive value, negative predictive value, accuracy, sensitivity, and specificity of common procedural adaptations reported to improve functional assessment safety and efficiency. We conclude with suggestions for clinicians and researchers.     

Is the Impact of Psychotherapy Processes on Outcomes Already Quacking and Waddling? Comment “A Primer on Psychotherapy Process Research (Pfeifer & Strunk, 2015)”

The article by Pfeifer and Strunk on psychotherapy process research offers a highly thoughtful review on the state of psychotherapy process research in cognitive therapy for depression, and the inherent challenges in establishing causal relationships between process and outcomes. In this commentary, I argue that the goal of internal validity in psychotherapy process research may be unattainable, and possibly unnecessary. Finally, I suggest that psychotherapy process research should shift from “does it affect change?” to “how does it affect change?”, “when does it affect change?”, and “for whom does it affect change?”     

Identifying correlates of self-stigma in adults who stutter: Further establishing the construct validity of the Self-Stigma of Stuttering Scale (4S)

PurposeThis study was set up to further establish the construct validity of the Self-Stigma of Stuttering Scale (4S) by demonstrating its associations with other established scales and replicating its original factor structure and reliability estimates.MethodWeb surveys were completed by 354 adults who stutter recruited from Board Certified Specialists in Fluency Disorders, and adult chapters of the National Stuttering Association. Participants completed a series of psychometrically validated scales measuring self-stigma, hope, empowerment, quality of life, social support, anxiety, depression, and self-rated speech disruption.ResultsHigher subscale and total stigma scores on the 4S were associated with significantly lower levels of hope, empowerment, quality of life, and social support, and significantly higher levels of anxiety, depression, and self-rated speech disruption. The original factor structure of the 4S was replicated, and reliability estimates of the subscales ranged from adequate to excellent.ConclusionsThe findings of this study support the construct validity of the 4S and its use by clinicians and researchers intending to measure the construct of self-stigma in adults who stutter.Educational objectives: Readers should be able to: (a) distinguish between the various components of self-stigma; (b) describe how the various components of the self-stigma model relate to hope, empowerment, quality of life, and social support, self-rated speech disruption, anxiety, and depression; (c) summarize the psychometric properties of the Self-Stigma of Stuttering Scale (4S) in terms of reliability, factor structure, and construct validity; (d) discuss how the 4S could be used in research and clinical practice.