Cognitive Avoidance Questionnaire: Factor structure and psychometric properties.
Abstract
Cognitive avoidance refers to strategies and efforts toward prevention of aversive experiences and events that provoke anxiety. The present study analyzed the factor structure and psychometric properties of the Spanish version of the Cognitive Avoidance Questionnaire (CAQ; Sexton & Dugas, 2008), an instrument that assesses five worry-related cognitive avoidance strategies. The Spanish translation was administered to a non-clinical sample of 614 participants (18-82 years). The total scale and subscales showed good to excellent internal consistency. Using confirmatory factor analysis, a five-factor model showed a good fit between the theoretical structure and the empirical data. Evidence of convergent and discriminant validity was obtained through analysis of the correlations of the questionnaire with measures of worry, thought suppression, rumination and coping styles. The results yielded satisfactory preliminary data on the Spanish adaptation of the CAQ, which could provide for further advances in clinical practice and research on cognitive processes and anxiety disorders.
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References
Akaike, H. (1987). Factor analysis and AIC. Psychometrika, 52, 317–332. doi:10.1007/BF02294359
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30, 217–237. doi:10.1016/j. cpr.2009.11.004
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Fifth Edit). Washington, DC: American Psychiatric Association.
Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103, 411-423. doi: 10.1037/0033-2909.103.3.411
Arbuckle, J. L. (2014). AMOS-23. Chicago, IL: IBM SPSS.
Barajas, S., Garra, L., & Ros, L. (2017). Avoidance in anxiety and depression: Adaptation of the Cognitive-Behavioral Avoidance Scale in a Spanish sample. The Spanish Journal of Psychology, 20, 1-11. doi: 10.1017/sjp.2017.16
Behar, E., DiMarco, I. D., Hekler, E. B., Mohlman, J., Staples, A. M., & Dobrow, I. (2009). Current theoretical models of generalized anxiety disorder (GAD): Conceptual review and treatment implications. Journal of Anxiety Disorders, 23, 1011–1023. doi: 10.1016/j.janxdis.2009.07.006
Bollen, K. A. (1989). Structural equations with latent variables. New York, NY: Wiley.
Borkovec, T. D., Alcaine, O. M., & Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. Generalized anxiety disorder: Advances in research and practice (pp. 77–108). New York, NY: Guilford.
Borkovec, T. D., Robinson, E., Pruzinsky, T., & DePree, J. A. (1983). Preliminary exploration of worry: Some characteristics and processes. Behaviour Research and Therapy, 21, 9–16. doi:10.1016/0005-7967(83)90121-3
Bryne, B. M. (2001). Structural equation modeling with AMOS: Basic concepts, applications, and programming. Mahwah, NJ: Lawrence Erlbaum Associates.
Capobianco, L., Morris, J. A., & Wells, A. (2018): Worry and rumination: do they prolong physiological and affective recovery from stress? Anxiety, Stress, & Coping, 31, 291-303. doi:10.1080/10615806.2018.1438723
Chen, Y., Peng, Y., Xu, H., & O´Brain, W. H. (2018). Age differences in stress and coping: Problem-focused strategies mediate the relationship between age and positive affect. The International Journal of Aging and Human Development, 86, 347-363. doi: 10.1177/0091415017720890
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. (2nd ed) Hillsdale, NJ: Lawrence Erlbaum.
Dickson, K. S., Ciesla, J. A., & Reilly, L. C. (2012). Rumination, worry, cognitive avoidance, and behavioral avoidance. Examination of temporal effects. Behaviour Therapy, 43, 629-640. doi: 10.1016/j.beth.2011.11.002
Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, H. (1998). Generalized anxiety disorder: A preliminary test of a conceptual model. Behaviour Research and Therapy, 36, 215–226. doi: 10.1016/S0005-7967(97)00070-3
Dugas, M. J., Savard, P., Gaudet, A., Turcotte, J., Laugesen, N., Robichaud, M., Francis, K., & Koerner, N. (2007). Can the components of a cognitive model predict the severity of generalized anxiety disorder? Behavior Therapy, 38, 169-178. doi: 10.1016/j.beth.2006.07.002
Eifert, G. H., & Forsyth, J. P. (2005). Acceptance and commitment therapy for anxiety disorders: A practitioner’s treatment guide to using mindfulness, acceptance and values-based behavior change strategies. Oakland, CA: New Harbinger Publications.
Eisma, M., & Stroebe, M. (2017). Rumination following bereavement: An overview.
Bereavement Care, 36, 58-64. doi: 10.1080/02682621.2017.1349291
González, M., Avero, P., Rovella, A. T., & Cubas, R. (2008). Structural validity and reliability of the Spanish version of the White Bear Suppression Inventory (WBSI) in a sample of the general Spanish population. Spanish Journal of Psychology, 11, 650-659.
Goodwin, H., Yiend, J., & Hirsch, C. (2017). Generalized anxiety disorder worry and attention to threat: A systematic review. Clinical Psychology Review, 54, 107-122. doi: 10.1016/j.cpr.2017.03.006
Gosselin, P., Langlois, F., Freeston, M. H., Ladouceur, R., Dugas, M. J., & Pelletier, O. (2002). Le Questionnaire d’e´vitement cognitif (QEC): De´veloppement et validation aupre`s d’adultes et d’adolescents [The CognitiveAvoidance Questionnaire (CAQ): Development and validation among adult and adolescent samples]. Journal de The´rapie Comportementale et Cognitive, 12, 24–37.
Hambleton, R. K. (2005). Issues, designs and technical guidelines for adapting tests into multiple languages and cultures. In R. K. Hambleton, P. F. Merenda, & S. D. Spielberger (Eds.), Adapting educational and psychological tests for cross-cultural assessment (pp. 3-38). Mahwah, NJ: Lawrence Erlbaum Associates.
Hayes, S. C. (2016). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies - republished article. Behavior Therapy, 47, 869-885. doi: 10.1016/j.beth.2016.11.006
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152-1168. doi:10.1037/0022-006X.64.6.1152
Hearn, C. S., Donovan, C. L., Spence, S. H., & March, S. (2018). Do worry and its associated cognitive variables alter following CBT treatment in a youth population with Social Anxiety Disorder? Results from a randomized controlled trial. Journal of Anxiety Disorders, 53, 46-57. doi:10.1016/j.janxdis.2017.11.005
Hirsch, C. R., Perman, G., Hayes, S., Eagleson, C., & Mathews, A. (2015). Delineating the role of negative verbal thinking in promoting worry, perceived threat, and anxiety. Clinical Psychological Science, 3, 637-647. doi: 10.1177/2167702615577349
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55. doi:10.1080/10705519909540118
International Test Commission. (2016). The ITC Guidelines for translating and adapting tests (Second edition). Retrieved from: https://www.intestcom.org/
Kirchner, T., & Forns, M. (2010). Spanish adaptation of Coping Responses Inventory-Adult. Madrid: TEA Ediciones.
Kline, R. B. (2011). Principles and practice of structural equation modeling (3ª Ed.). New York: The Guilford Press.
Lobo, A., Saz, P., Marcos, G., & Zaracemp, G. T. (2002). Spanish version of the Mini-Mental Cognitive Test (MEC). Madrid: TEA Ediciones.
Marsh, H. W., & Hocevar, D. (1985). Application of confirmatory factor analysis to the study of self-concept: first-and higher order factor models and their invariance across groups. Psychological Bulletin, 97, 562–582. doi: 10.1037/0033-2909.97.3.562
Matthews G., & Wells A. (2004). Rumination, depression and metacognition: The S-REF Model. In C. Papageorgiou & A. Wells (Eds.), Depressive rumination. Nature, theory and treatment (pp. 125–151). Chichester, UK: John Wiley & Sons.
Meyer, T. J., Miller, M. L., Metzger, R. L., y Brokovec, T. D. (1990). Development and validation of the Penn State Wory Questionnaire. Behaviour Research and Therapy, 28, 487-¬‐495. doi: 10.1016/0005-¬‐7967(90)90135-6
Moos, R. (1993). Coping Responses Inventory: CRI Adult-Form. Odessa, Ukraine: Psychological Assessment Resources. Inc.
Moulds, M. L., Kandris, E., Starr, S., & Wong, A. C. M. (2007). The relationship between rumination, avoidance and depression in a non-clinical sample. Behaviour Research and Therapy, 25, 251–261. doi: 10.1016/j.brat.2006.03.003
Newman, M. G., Llera, S. J., Erickson, T. M., Przeworski, A., & Castonguay, L. G. (2013). Worry and Generalized Anxiety Disorder: A review and theoretical synthesis of evidence on nature, etiology, mechanisms, and treatment. Annual Review of Clinical Psychology, 9, 275-297. doi: 10.1146/annurev-clinpsy-050212-185544
Nieto, M., Romero, D., Ros, L., Zabala, C., Martínez, M., Ricarte, J. J., Serrano, J. P., & Latorre, J. M. (2020). Differences in coping strategies between young and older adults: The role of executive functions. The International Journal of Aging and Human Development. doi: 10.1177/0091415018822040
Nolen-Hoeksema, S. (2000). The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology, 109, 504–511. doi:10.1037/0021-843X.109.3.504
Østefjells, T., Melle, I., Aminoff, S. R., Hellvin, T., Hagen, R., Lagerberg T. V., … Røssberg, J. I. (2017). An exploration of metacognitive beliefs and thought control strategies in bipolar disorder. Comprehensive Psychiatry, 73, 84-92. doi: 10.1016/j.comppsych.2016.11.008
Raes, F., Hermans, D., Williams, J. M. G., Bijttebier, P., & Eelen, P. (2007). A “Triple W” model of rumination on sadness: Why am I feeling sad, what’s the meaning of my sadness, and wish I could stop thinking about my sadness (but I can’t). Cognitive Therapy and Research, 32, 526–541. doi:10.1007/s10608-007-9137-y
Raes, F., Hermans, D., Williams, J. M. G., & Eelen, P. (2007). A sentence completion procedure as an alternative to the Autobiographical Memory Test for assessing overgeneral memory in non-clinical populations. Memory, 15, 495–507. doi: 10.1080/09658210701390982
Rousseeuw P. J., & Leroy A. M. (1987). Robust regression and outlier detection. New York, NY: John Wiley & Sons, Inc.
Ricarte, J. J., Aizpurúa, E., Ros, L., Latorre, J. M., & Raes, F. (2018). Psychometric properties of the Spanish Short Depressive Rumination Scale in a nonclinical sample. The Spanish Journal of Psychology, 21, 1-10. doi: 10.1017/sjp.2018.35
Robichaud, M., Dugas, M. J., & Conway, M. (2003). Gender differences in worry and associated cognitive-behavioral variables. Journal of Anxiety Disorders, 17, 501- 516. doi: 10.1016/S0887-6185(02)00237-2
Sagui-Henson, S. J. (2017). Cognitive Avoidance. Encyclopedia of Personality and Individual Differences, 1–3. doi:10.1007/978-3-319-28099-8_964-1
Sandín, B., Chorot, P., Valiente, R. M., & Lostao, L. (2009). Validación española del cuestionario de preocupación PSWQ: estructura factorial y propiedades psicométricas [Spanish validation of the PSWQ concern questionnaire: factor structure and psychometric properties]. Revista de Psicopatología y Psicología Clínica, 14, 107-122. doi: 10.5944/rppc.vol.14.num.2.2009.4070
Schäfer, J. Ö., Naumman, E., Holmes, E. A., Tuschen-Caffier, B., & Samson, A. C. (2017). Emotion regulation strategies in depressive and anxiety symptoms in youth: A meta-analytic review. Journal of Youth and Adolescence, 46, 261-276. doi: 10.1007/s10964-016-0585-0
Segerstrom S. C., Tsao J. C. I., Alden L. E., & Craske M. G. (2000). Worry and rumination: Repetitive thought as a concomitant and predictor of negative mood. Cognitive Therapy and Research, 24, 671–688. doi: 10.1023/A:1005587311498
Servatius, R. J. (2016). Avoidance: From basic science to psychopathology. Frontiers in Behavioral Neuroscience, 10, 15. doi: 10.3389/fnbeh.2016.00015
Sexton, K. A., & Dugas, M. J. (2008). The Cognitive Avoidance Questionnaire: Validation of de English translation. Journal of Anxiety Disorders, 22, 335-370. doi: 10.1016/j.janxdis.2007.04.005
Struijs, S. Y., Lamers, F., Rinck, M., Roelofs, K., Spinhoven, P., & Penninx, B.W. J. (2018). The predictive value of approach and avoidance tendencies on the onset and course of depression and anxiety disorders. Depression and Anxiety, 35, 551-559. doi: 10.1002/da.22760
Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). Boston, MA: Allyn & Bacon.
Watkins, E. D., & Moulds, M. (2009). Thought Control Strategies, Thought Suppression, and Rumination in Depression. International Journal of Cognitive Therapy, 2, 235-251. doi:10.1521/ijct.2009.2.3.235
Wegner, D. M., & Zanakos, S. (1994). Chronic thought suppression. Journal of Personality, 62, 615–640. doi: 10.1111/j.1467-6494. 1994.tb00311.x
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