The Cognitive Appraisal of Health Scale: development of psychometric evaluation

The purpose of this study was to develop and evaluate the psychometric properties of the Cognitive Appraisal of Health Scale (CAHS). The CAHS was developed to measure multiple dimensions of primary and secondary appraisals associated with health-related events. Items were generated for primary appraisal scales of threat, harm/loss, challenge, and benign/irrelevant, and secondary appraisal coping options and resources. The CAHS was tested in a sample of 201 women with breast cancer. Following tests of item analysis, reliability, and construct and concurrent validity, the CAHS was reduced to 28 items. During factor analysis a four-factor solution explained 60% of the total variance and represented the proposed primary appraisal dimensions. Intercorrelations among primary and secondary appraisals were consistent with theory (p < 0.01). Support for concurrent validity was provided by the clinically relevant differences in appraisal by time since diagnosis. The primary appraisal scale estimates of internal consistency (theta) were all greater that .70. Findings indicated beginning support for reliability and validity of the CAHS as a measure of cognitive appraisal for health-related events.