Assessment of Chronic Illness-Related Cognitive Fusion: Preliminary Development and Validation of a New Scale with an IBD Sample
Open accessAbstract
Although research recognizes the advantages of creating specific content measures, no specific measure of chronic illness-related cognitive fusion had been developed to date. The current study presents the development and validation of the Cognitive Fusion Questionnaire-Chronic Illness (CFQ-CI) in a sample of inflammatory bowel disease (IBD) patients and the analysis of the role of this construct in the psychological health of those patients. Results indicated that the 7-item CFQ-CI was a unidimensional measure of cognitive fusion in patients with chronic illnesses, and that scores had adequate/good internal consistency and construct, convergent, and discriminant validity. This study also showed that chronic illness-related cognitive fusion as assessed by the CFQ-CI acted as a mediator in the association between both IBD-related symptoms and shame with quality of life. The development of the CFQ-CI may thus contribute to a better understanding of the mechanisms influencing functional outcomes in chronic illness.
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The correlations of CFQ-CI with depression, social anxiety, and self-compassion support the concurrent validity of CFQ-CI.
“These results are consistent with the original version (29), showing the concurrent validity of CFQ-CI.”
From Psychometric Properties of the Persian Version of Cognitive Fusion Questionnaire-Chronic Illness in Multiple Sclerosis (2022) · cites this paper as [29]
The Construct validity section reports correlations between the CFQ-CI and other measures, and the Discussion concludes that its scores appear valid. But the reported correlations concern measures such as general cognitive fusion, shame, brooding, and quality of life—not depression, social anxiety, or self-compassion. The source therefore supports the general validity point, but not validity based on those specific correlations. (LLM, conf=0.83)
Experimental — accuracy not yet measuredChanges in cognitive fusion, rather than IBD symptomatology, predicted improvements in psychological health.
“Moreover, changes in cognitive fusion rather than IBD symptomatology predicted improvements in psychological health.”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [32]
The path-analysis results report that cognitive fusion predicted psychological quality of life, but also that IBD symptomatology indirectly predicted it through shame and cognitive fusion. The Discussion states that the study was cross-sectional and calls for longitudinal research; it did not measure changes or improvements over time. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCognitive fusion is negatively associated with psychological and physical health in IBD and mediates the relationship between chronic-illness-related stigma and psychological quality of life.
“For example, the ACT process of cognitive fusion—the tendency to perceive and act on thoughts through a context of literality—has been observed to be negatively associated with psychological and physical health in IBD and mediates the relationship between chronic-illness-related stigma and psychological QoL [31,32].”
From Brief and Telehealth Acceptance and Commitment Therapy (ACT) Interventions for Stress in Inflammatory Bowel Disease (IBD): A Series of Single Case Experimental Design (SCED) Studies (2022) · cites this paper as [32]
The Discussion reports that chronic illness-related cognitive fusion was associated with lower psychological and physical well-being in the IBD sample. The path-model results report that it partially mediated the relationship between chronic illness-related shame and psychological quality of life, but the measured factor was shame, not stigma. Page numbers were not supplied in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe internal consistency of CFQ-CI agrees with the original version's high internal consistency estimates.
“This finding agrees with our predictions and the findings of the original version (29), reporting high internal consistency estimates.”
From Psychometric Properties of the Persian Version of Cognitive Fusion Questionnaire-Chronic Illness in Multiple Sclerosis (2022) · cites this paper as [29]
The 1-factor structure of CFQ-CI found in this study is consistent with the original version in inflammatory bowel disease patients.
“This finding is consistent with the original version showing the 1-factor structure in patients with IBD (29).”
From Psychometric Properties of the Persian Version of Cognitive Fusion Questionnaire-Chronic Illness in Multiple Sclerosis (2022) · cites this paper as [29]
CFQ-CI has good psychometric properties.
“CFQ-CI has good psychometric properties (29).”
From Psychometric Properties of the Persian Version of Cognitive Fusion Questionnaire-Chronic Illness in Multiple Sclerosis (2022) · cites this paper as [29]
Initial evidence suggests ACT may be an appropriate intervention to target psychological suffering in people with an IBD diagnosis.
“Initial evidence suggests ACT may be an appropriate intervention to target psychological suffering in people with an IBD diagnosis.”
Test-retest reliability was not assessed in the present study.
“However, in contrast to the results of IBD (29), testretest reliability was not assessed in the present study.”
From Psychometric Properties of the Persian Version of Cognitive Fusion Questionnaire-Chronic Illness in Multiple Sclerosis (2022) · cites this paper as [29]
The citation is attached to the contrast with the IBD study, which implies that study assessed test–retest reliability; the statement about the citing authors’ present study is their own. The cited paper’s Statistical analyses and Reliability sections report internal consistency using Cronbach’s alpha, but searches for “test-retest” and reliability over time found no test–retest assessment in our copy. No page numbers were available. (LLM, conf=0.70)
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- Authors
- Trindade, I. A., Ferreira, C., & Pinto-Gouveia, J.
- Affiliations
- University of Coimbra (PT)
- Corresponding author
- Trindade, Inês A.
- Venue
- Journal of Clinical Psychology in Medical Settings
- Published
- 2018-02-19
- Volume
- 25
- Issue
- 4
- Pages
- 356-366
- ISSN
- 1068-9583 (ISSN-L)
- 1573-3572
- OpenAlex
- W2788391942
- Cited by
- 18
- References
- 52
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 2
- FWCI
- 2.35
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- Journal of Clinical Psychology in Medical Settings (publishedVersion)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion)
- Funders
- Fundação para a Ciência e a Tecnologia (SFRH/BD/101906/2014)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- cognitive fusion, chronic disease, inflammatory bowel disease, scale development, mental health, shame, quality of life, mediation
- MeSH terms
- Adult, Aged, Attitude to Health, Chronic Disease, Cognition, Female, Humans, Male, Middle Aged, Portugal, Psychometrics, Quality of Life, Surveys and Questionnaires, Shame, Reproducibility of Results, Inflammatory Bowel Diseases, Young Adult, Acceptance and Commitment Therapy
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