The Behavioural Responses to Illness Questionnaire (BRIQ): a new predictive measure of medically unexplained symptoms following acute infection

Psychol Med. 2005 Apr;35(4):583-93. doi: 10.1017/s0033291704003484.


Background: The aim of this study was to design a self-report measure of behavioural responses during the acute phase of an illness, in order to assess the importance of these behaviours in the development of ongoing medically unexplained syndromes.

Method: An initial pool of items derived from theoretical models and clinical observation, was piloted on a group of 312 university students to assess the factor structure of the scale and the best fit items. The scale was further validated in a second study of 758 patients who were experiencing Campylobacter gastroenteritis. At 3 months post-infection, patients were sent a second questionnaire assessing symptoms of irritable bowel syndrome (IBS).

Results: Principal components analysis of the items in the student sample yielded a four-factor solution, labelled all-or-nothing behaviour, limiting behaviour, emotional support seeking and practical support seeking. The factor structure was confirmed in the Campylobacter sample, and internal reliability was good. All-or-nothing behaviour was associated with IBS at 3 months post-infection. In contrast, limiting behaviour and practical support seeking at the time of infection appeared to be protective.

Conclusion: The results suggest that this is a valid and reliable measure that can predict the development of a medically unexplained syndrome after acute infection. Overdoing things at the time of infection and then needing to rest for prolonged periods (all-or-nothing behaviour), appears to be a particular risk factor for the development of IBS. Targeted interventions at the time of infection may improve coping and prevent symptoms from becoming chronic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Campylobacter Infections / psychology*
  • Convalescence
  • Female
  • Follow-Up Studies
  • Foodborne Diseases / psychology
  • Gastroenteritis / psychology*
  • Humans
  • Influenza, Human / psychology
  • Irritable Bowel Syndrome / psychology*
  • Male
  • Middle Aged
  • Personality Inventory / statistics & numerical data*
  • Pilot Projects
  • Psychometrics
  • Reference Values
  • Reproducibility of Results
  • Sick Role*
  • Social Support
  • Somatoform Disorders / diagnosis*
  • Somatoform Disorders / psychology
  • Statistics as Topic
  • Students / psychology
  • Syndrome