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A pilot validation of a modified Illness Perceptions Questionnaire designed to predict response to cognitive therapy for psychosis

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      Abstract

      Background and objectivesClinical responsiveness to cognitive behavioural therapy for psychosis (CBTp) varies. Recent research has demonstrated that illness perceptions predict active engagement in therapy, and, thereby, better outcomes. In this study, we aimed to investigate the psychometric properties of a modification of the Illness Perceptions Questionnaire (M-IPQ) designed to predict response following CBTp.MethodsFifty-six participants with persistent, distressing delusions completed the M-IPQ; forty before a brief CBT intervention targeting persecutory ideation and sixteen before and after a control condition. Additional predictors of outcome (delusional conviction, symptom severity and belief inflexibility) were assessed at baseline. Outcomes were assessed at baseline and at follow-up four to eight weeks later.ResultsThe M-IPQ comprised two factors measuring problem duration and therapy-specific perceptions of Cure/Control. Associated subscales, formed by summing the relevant items for each factor, were reliable in their structure. The Cure/Control subscale was also reliable over time; showed convergent validity with other predictors of outcome; predicted therapy outcomes; and differentially predicted treatment effects.LimitationsWe measured outcome without an associated measure of engagement, in a small sample. Findings are consistent with hypothesis and existing research, but require replication in a larger, purposively recruited sample.ConclusionsThe Cure/Control subscale of the M-IPQ shows promise as a predictor of response to therapy. Specifically targeting these illness perceptions in the early stages of cognitive behavioural therapy may improve engagement and, consequently, outcomes.

      Highlights

      •Illness beliefs predicted response to cognitive therapy in psychosis (CBTp).•Key predictors concerned the likelihood of curing or controlling problems.•The Cure/control subscale was expanded to include CBT-specific change items.•Findings could help to more efficiently target limited provision in routine services.•‘Pre-therapy’ interventions could target these beliefs to improve outcomes.

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      Most cited references 51

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      The brief illness perception questionnaire.

      This study evaluates the Brief Illness Perception Questionnaire (Brief IPQ), a nine-item scale designed to rapidly assess the cognitive and emotional representations of illness. We assessed the test-retest reliability of the scale in 132 renal outpatients. We assessed concurrent validity by comparing the Brief IPQ with the Illness Perception Questionnaire-Revised (IPQ-R) and other relevant measures in 309 asthma, 132 renal, and 119 diabetes outpatients. Predictive validity was established by examining the relationship of Brief IPQ scores to outcomes in a sample of 103 myocardial infarction (MI) patients. Discriminant validity was examined by comparing scores on the Brief IPQ between five different illness groups. The Brief IPQ showed good test-retest reliability and concurrent validity with relevant measures. The scale also demonstrated good predictive validity in patients recovering from MI with individual items being related to mental and physical functioning at 3 months' follow-up, cardiac rehabilitation class attendance, and speed of return to work. The discriminant validity of the Brief IPQ was supported by its ability to distinguish between different illnesses. The Brief IPQ provides a rapid assessment of illness perceptions, which could be particularly helpful in ill populations, large-scale studies, and in repeated measures research designs.
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        The illness perception questionnaire: A new method for assessing the cognitive representation of illness

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          The revised illness perception questionnaire (IPQ-R)

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            Author and article information

            Affiliations
            [a ]King's College London, Institute of Psychiatry, Department of Psychology, PO77, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
            [b ]King's College London, Institute of Pharmaceutical Science, 5th Floor Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
            [c ]Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester Academic Health Science Centre, 4.304 Jean McFarlane Building, Oxford Road, Manchester M13 9PL, UK
            [d ]Division of Psychiatry, University College, London, 67-73 Riding House Street, London W1W 7EJ, UK
            [e ]University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK
            [f ]School of Psychology, University of Sussex, Pevensey Building, Falmer BN1 9QH, UK
            Author notes
            []Corresponding author. Tel.: +44 020 7848 5028; fax: +44 020 7848 5006. Suzanne.Jolley@ 123456kcl.ac.uk
            Contributors
            Journal
            J Behav Ther Exp Psychiatry
            J Behav Ther Exp Psychiatry
            Journal of Behavior Therapy and Experimental Psychiatry
            Elsevier
            0005-7916
            1873-7943
            1 December 2014
            December 2014
            : 45
            : 4
            : 459-466
            25011076
            4157321
            S0005-7916(14)00045-7
            10.1016/j.jbtep.2014.06.003
            © 2014 The Authors
            Categories
            Article

            Clinical Psychology & Psychiatry

            schizophrenia, cbt, engagement, ipq, therapy outcome

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