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A Breathlessness Catastrophizing Scale for chronic obstructive pulmonary disease.

Brahm K Solomon1, Keith G Wilson2, Peter R Henderson2

  • 1School of Psychology, University of Ottawa, Canada.

Journal of Psychosomatic Research
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PubMed
Summary

The Breathlessness Catastrophizing Scale (BCS) reliably measures catastrophizing in chronic obstructive pulmonary disease (COPD) patients. High catastrophizing did not impede functional gains from pulmonary rehabilitation.

Keywords:
AnxietyCatastrophizingChronic obstructive pulmonary diseaseDepressionDisabilityRehabilitation

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Area of Science:

  • Respiratory Medicine
  • Psychology
  • Rehabilitation Science

Background:

  • Catastrophizing breathlessness is linked to disability in chronic obstructive pulmonary disease (COPD).
  • Existing assessment tools for breathlessness catastrophizing are limited.
  • A validated scale is needed to measure this psychological construct in COPD patients.

Purpose of the Study:

  • To validate the initial 13-item Breathlessness Catastrophizing Scale (BCS).
  • To assess the reliability and validity of the BCS in patients with severe COPD.
  • To determine the scale's sensitivity to change following pulmonary rehabilitation.

Main Methods:

  • Pulmonary rehabilitation inpatients (N=242 at admission, n=186 at discharge) completed spirometry, functional tests, and questionnaires.
  • The Breathlessness Catastrophizing Scale (BCS) was administered.
  • Convergent validity was assessed by correlating BCS scores with measures of anxiety sensitivity, depression, and self-efficacy.

Main Results:

  • The BCS demonstrated excellent internal consistency (Cronbach's alpha=.96) and a unifactorial structure.
  • BCS scores showed robust improvement with rehabilitation (d=.43), indicating sensitivity to change.
  • The scale correlated with anxiety sensitivity, depression, and self-efficacy, but not directly with walk or stair-climbing test performance.

Conclusions:

  • The BCS is a reliable and valid measure for assessing catastrophizing in severe COPD.
  • The scale is sensitive to changes occurring during pulmonary rehabilitation.
  • High levels of breathlessness catastrophizing do not appear to hinder functional improvements achieved through inpatient pulmonary rehabilitation.