The construct validity of the illness cognition questionnaire: the robustness of the three-factor structure across patients with chronic pain and chronic fatigue

Int J Behav Med. 2010 Jun;17(2):90-6. doi: 10.1007/s12529-009-9059-z.


Background: The Illness Cognition Questionnaire (ICQ; Evers et al., J Consult Clin Psychol, 69:1026-1036, 2001) assesses three ways of cognitively evaluating the stressful and aversive character of a chronic illness: helplessness, acceptance, and perceived benefits.

Purpose: The purpose of this study was to evaluate the construct validity of the ICQ in individuals with chronic pain and patients with chronic fatigue.

Method: The ICQ was administered to 821 individuals with chronic pain and 295 patients with chronic fatigue. Confirmatory factor analyses were performed to assess the hypothesized three-factor structure, containing the factors "helplessness," "acceptance," and "perceived benefits." A multigroup analysis was performed to investigate the stability of the factor structure in both groups.

Results: Results confirmed the three-factor structure in the two samples. The factor structure was invariant across individuals with chronic pain and chronic fatigue.

Conclusion: As the three-factor structure provided a good fit in both groups, we confirm the usefulness of the subscale scores in research and clinical practice.

Publication types

  • Evaluation Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Cognition*
  • Factor Analysis, Statistical
  • Fatigue / psychology*
  • Female
  • Helplessness, Learned*
  • Humans
  • Male
  • Middle Aged
  • Pain / psychology*
  • Pain Perception*
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Surveys and Questionnaires* / standards
  • Young Adult