Depression and cognitions after stroke: validation of the Stroke Cognitions Questionnaire Revised (SCQR)

The Stroke Cognitions Questionnaire Revised (SCQR) was developed to assess the frequency of positive and negative cognitions of stroke patients. This paper aims to examine the construct validity, internal consistency, test--retest and inter-rater reliability of the SCQR.

The SCQR was constructed by revising the Stroke Cognitions Questionnaire and developing new items from the cognitive-behavioural-therapy treatment notes of depressed stroke patients. Fifty hospitalised stroke patients were assessed on the SCQR and the Beck Depression Inventory II. Test - retest reliability over a 1-week interval and inter-rater reliability were evaluated with the first 20 patients.

Total scores on the SCQR and the total number of positive and negative cognitions reported were significantly correlated with scores on the Beck Depression Inventory II (r = 0.54-0.80, p < 0.001). The scale had high internal consistency (Cronbach's alpha coefficient of 0.91). Depressed patients reported significantly more negative cognitions and significantly less positive cognitions than those not depressed. Excellent agreement was found between two raters for all items on the SCQR (Kappa 0.89-1.00), and test--retest reliability was also good (r = 0.81, p < 0.001).

The SCQR is a reliable and valid measure of cognitions relevant to stroke patients. The pattern of cognitions was similar to that found in primary depression (more negative and less positive cognitions), suggesting that therapies developed from the cognitive model of depression may be appropriate for stroke patients.