The factor structure and reliability of the Illness Attitude Scales in a student and a patient sample

Abstract

Background: The Illness Attitude Scales (IAS), designed by Kellner in 1986, assesses fears, beliefs, and attitudes associated with hypochondriasis and abnormal illness behaviour. However, its factor structure is, especially for translations of the IAS, not sufficiently explored. Thus, the present Study aimed to analyse the factor structure of the IAS in a German student and a patient population using exploratory factor analysis.

The Illness Attitude Scales

“…The test-retest reliability of the IAS was also very high when it was assessed in clinical populations [25, 36, 63, 48]. In general, in medical outpatients (re-tested after a mean period of 4.2 ± 4.3 weeks) the ‘health anxiety’ and ‘illness behaviour’ factors had retest correlations of 0.93 and 0.87, respectively [25].…”

“…Five studies [25, 28,46,47,48] found 2 factors labelled by Speckens et al [25] as ‘health anxiety’ and ‘illness behaviour’. The first dimension was closer to the core features of hypochondriasis, and contained items mainly from the worry about illness, concerns about pain, thanatophobia, disease phobia and hypochondriacal beliefs original IAS scales.…”

“…Six studies [48,50,51,52,53,54] instead revealed 4- or 5-factor solutions which, with some exceptions [48, 50], shared 4 components that tapped in to: (1) fear of illness, death, disease and pain; (2) effects of symptoms on daily life; (3) disease phobia and conviction; (4) avoidance of harmful health habits. Except for a study on 198 patients with chronic pain [51], these factors were obtained using samples of undergraduate students (n = 101, 197, 296, 309, 390, respectively).…”

“…In normal subjects the IAS showed high test-retest reliability, with correlation coefficients between 0.44 for hypochondriacal beliefs [62] and 1.00 for disease phobia [10] on retest evaluations conducted from 1 week to 6 months later [10, 42, 44, 48, 62]. …”

“…This solution was obtained in samples comprising 130 general medical outpatients [25], 113 general practice patients [25], 204 subjects from general population [25], 570 patients with mental and psychophysiological disorders [28], 199 chest pain patients [46], 82 psychiatric patients hospitalized for gastrointestinal complaints [47] and 130 psychosomatic patients with medically unexplained symptoms [48]. In 2 studies [46, 47] a separate factor, identical to the original health habits scale, also emerged.…”