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The cardiac anxiety questionnaire: development and preliminary validity
G H Eifert1, R N Thompson, M J Zvolensky
1Department of Psychology, West Virginia University, Morgantown 26505-6040, USA.
Insights
This study introduces the Cardiac Anxiety Questionnaire (CAQ) to identify heart-focused anxiety (HFA) in patients. The CAQ shows promise in measuring fear, avoidance, and attention related to cardiac concerns.
Area of Science:
- Psychology
- Cardiology
- Psychometrics
Background:
- Heart-focused anxiety (HFA) is the fear of cardiac stimuli and sensations.
- HFA is often unrecognized and misdiagnosed in patients with or without heart disease.
- There is a need for a reliable tool to measure HFA.
Purpose of the Study:
- To develop and psychometrically evaluate the Cardiac Anxiety Questionnaire (CAQ).
- To measure HFA in cardiology patients.
- To assess the reliability and validity of the CAQ.
Main Methods:
- Study 1: 188 cardiology patients completed the CAQ; item, factor, and reliability analyses were performed.
- Study 2: 42 patients completed the CAQ and other anxiety measures for convergent and divergent validity.
- Development of an 18-item CAQ with a three-factor solution (fear, avoidance, attention).
Main Results:
- The CAQ demonstrated good internal consistency for total and subscale scores.
- Preliminary validity results were promising.
- The CAQ identified a three-factor structure related to HFA.
Conclusions:
- The CAQ appears to be a useful instrument for identifying patients with elevated HFA.
- Further psychometric evaluation is needed to confirm the CAQ's reliability and validity.
- The CAQ can aid in identifying HFA in patients with and without heart disease.
Abstract:
Heart-focused anxiety (HFA) is the fear of cardiac-related stimuli and sensations because of their perceived negative consequences. Although HFA is common to a wide variety of persons who experience chest pain and distress, it often is unrecognized and misdiagnosed, particularly in cardiology and emergency room patients without and with heart disease. To address these concerns, this article reports on the development and preliminary psychometric evaluation of the Cardiac Anxiety Questionnaire (CAQ) designed to measure HFA. In Study 1, 188 cardiology patients completed the CAQ. Item and factor analyses indicated a three-factor solution pertaining to heart-related fear, avoidance, and attention. Reliability analysis of the 18-item CAQ revealed good internal consistency of the total and subscale scores. In Study 2, 42 patients completed the CAQ and several other anxiety-related questionnaires to assess its convergent and divergent properties. Although preliminary validity results are promising, further psychometric study is necessary to cross-validate the CAQ, examine its test-retest reliability, and confirm the stability of the factor structure. Taken together, the CAQ appears to assess HFA, and may therefore be a useful instrument for identifying patients with elevated HFA without and with heart disease.