Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-16T18:24:17.127Z Has data issue: false hasContentIssue false

Psychometric Properties of the Worry Behaviors Inventory: Replication and Extension in a Large Clinical and Community Sample

Published online by Cambridge University Press:  31 July 2017

Alison E. J. Mahoney*
Affiliation:
Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Sydney, NSW, Australia
Megan J. Hobbs
Affiliation:
Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Sydney, NSW, Australia
Jill M. Newby
Affiliation:
Department of Psychology, University of New South Wales, Sydney, NSW, Australia
Alishia D. Williams
Affiliation:
Department of Clinical Psychology, Utrecht University, The Netherlands
Gavin Andrews
Affiliation:
Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Sydney, NSW, Australia
*
*Correspondence to Dr Alison Mahoney, Clinical Research Unit for Anxiety and Depression, University of New South Wales at St Vincent's Hospital, Level 4 O'Brien Centre, 394–404 Victoria Street, Darlinghurst, NSW 2010, Australia. E-mail: [email protected]

Abstract

Background: The use of maladaptive behaviors by individuals with generalized anxiety disorder (GAD) is theoretically important and clinically meaningful. However, little is known about the specificity of avoidant behaviors to GAD and how these behaviors can be reliably assessed. Aims: This study replicated and extended the psychometric evaluation of the Worry Behaviors Inventory (WBI), a brief self-report measure of avoidant behaviors associated with GAD. Method: The WBI was administered to a hospital-based sample of adults seeking treatment for symptoms of anxiety and/or depression (n = 639) and to a community sample (n = 55). Participants completed measures of symptom severity (GAD, depression, panic disorder, health anxiety, and personality disorder), and measures of checking, reassurance-seeking and behavioral inhibition. Analyses evaluated the factor structure, convergent, divergent, incremental, and discriminant validity, as well the temporal stability and treatment sensitivity of the WBI. Results: The two-factor structure found in the preliminary psychometric evaluation of the WBI was replicated. The WBI was sensitive to changes across treatment and correlated well with measures of GAD symptom severity and maladaptive behaviors. The WBI was more strongly related to GAD symptom severity than other disorders. The WBI discriminated between clinical and community samples. Conclusions: The WBI provides clinicians and researchers with a brief, clinically meaningful index of problematic behaviors that may guide treatment decisions and contribute to our understanding of maintaining factors in GAD.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G., Hobbs, M. J., Borkovec, T. D., Beesdo, K., Craske, M. G., Heimberg, R. G. et al. (2010). Generalised worry disorder: a review of DSM-IV generalised anxiety disorder and options for DSM-V. Depression and Anxiety, 27, 134147.CrossRefGoogle ScholarPubMed
Andrews, G., Mahoney, A.E.J, Hobbs, M.J. and Genderson, M. (2016). Treatment of Generalized Anxiety Disorder: Therapist Guides and Patient Manual. Oxford: Oxford University Press.CrossRefGoogle Scholar
Abramowitz, J. S. and Deacon, B. J. (2006). Psychometric properties and construct validity of the obsessive-compulsive inventory-revised: replication and extension with a clinical sample. Journal of Anxiety Disorders, 20, 10161035.CrossRefGoogle ScholarPubMed
American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual for Mental Disorders (5th edition). Washington, DC.Google Scholar
Beard, C., Hsu, K. J., Rifkin, L. S., Busch, A. B. and Björgvinsson, T. (2016). Validation of the PHQ-9 in a psychiatric sample. Journal of Affective Disorders, 193, 267273.CrossRefGoogle Scholar
Beesdo-Baum, K., Jenjahn, E., Hofler, M., Lueken, U., Becker, E. S. and Hoyer, J. (2012). Avoidance, safety behavior, and reassurance-seeking in generalized anxiety disorder. Depression and Anxiety, 29, 948957.CrossRefGoogle ScholarPubMed
Berle, D., Starcevic, V., Moses, K., Hannan, A., Milicevic, D. and Sammut, P. (2011). Preliminary validation of an ultra-brief version of the Penn State Worry Questionnaire. Clinical Psychology and Psychotherapy, 18, 339346.CrossRefGoogle ScholarPubMed
Borkovec, T. D., Alcaine, O. M. and Behar, E. (2004). Avoidance theory of worry and generalized anxiety disorder. In Heimberg, R. G., Turk, C. L. and Mennin, D. (eds), Generalized Anxiety Disorder: Advances in Research and Practice. New York, NY: Guilford Press.Google Scholar
Browne, M. W. and Cudeck, R. (1993). Alternative ways of assessing model fit. In Bollen, K. A. and Long, J. S. (eds), Testing Structural Equation Models, pp. 136162. Beverly Hills, CA: Sage.Google Scholar
Carver, C. S. and White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS scales. Journal of Personality and Social Psychology, 67, 319333.CrossRefGoogle Scholar
Coleman, S. L., Pieterfesa, A. S., Holaway, R. M., Coles, M. E. and Heimberg, R. G. (2011). Content and correlates of checking related to symptoms of obsessive compulsive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 25, 293301.CrossRefGoogle ScholarPubMed
Conradt, M., Cavanagh, M., Franklin, J. and Rief, W. (2006). Dimensionality of the Whiteley Index: Assessment of hypochondriasis in an Australian sample of primary care patients. Journal of Psychosomatic Research, 60, 137143.CrossRefGoogle Scholar
Cougle, J. R., Fitch, K. E., Finchman, F. D., Riccardi, C. J., Keough, M. E. and Timpano, K. R. (2012). Excessive reassurance seeking and anxiety pathology: tests of incremental associations and directionality. Journal of Anxiety Disorders, 26, 117125.CrossRefGoogle ScholarPubMed
Dickson, K. S., Ciesla, J. A. and Reilly, L. C. (2012). Rumination, worry, cognitive avoidance, and behavioral avoidance: Examination of temporal effects. Behavior Therapy, 43, 629640.CrossRefGoogle ScholarPubMed
Diedenhofen, B. and Musch, J. (2015). cocor: a comprehensive solution for the statistical comparison of correlations. PLoS ONE, 10, e0121945.CrossRefGoogle ScholarPubMed
Dugas, M. J., Gagnon, F., Ladouceur, R. and Freeston, M. H. (1998). Generalized anxiety disorder: a preliminary test of a conceptual model. Behavior Research and Therapy, 36, 215226.CrossRefGoogle ScholarPubMed
Fink, P., Ewald, H., Jensen, J., Sorensen, L., Engberg, M., Holm, M. and Munk-Jorgensen, P. (1999). Screening for somatization and hypochondriasis in primary care and neurological in-patients: A seven-item scale for hypochondriasis and somatization. Journal of Psychosomatic Research, 46, 261273.CrossRefGoogle ScholarPubMed
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G. et al. (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological Assessment, 14, 485496.CrossRefGoogle ScholarPubMed
Germans, S., Van Heck, G. L., Moran, P. and Hodiamont, P. G. (2008). The Self-report Standardized Assessment of Personality-abbreviated Scale: Preliminary results of a brief screening test for personality disorders. Personality and Mental Health, 2, 7076.CrossRefGoogle Scholar
Goddard, E., Wingrove, J. and Moran, P. (2015). The impact of comorbid personality difficulties on response to IAPT treatment for depression and anxiety. Behavior Research and Therapy, 73, 17.CrossRefGoogle ScholarPubMed
Goldberg, D. P., Andrews, G., Krueger, R. F. and Hobbs, M. J. (2009). Emotional disorders: Cluster 4 of the proposed meta-structure for DSM-V. Psychological Medicine, 39, 20432059.CrossRefGoogle ScholarPubMed
Houck, P. R., Spiegel, D. A., Shear, M. K. and Rucci, P. (2002). Reliability of the self-report version of the panic disorder severity scale. Depression and Anxiety, 15, 183185.CrossRefGoogle ScholarPubMed
Hu, L. T. and Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3, 424453.CrossRefGoogle Scholar
Kertz, S. J., Lee, J. and Björgvinsson, T. (2014). Psychometric properties of abbreviated and ultra-brief versions of the Penn State Worry Questionnaire. Psychological Assessment, 14, 11461154.CrossRefGoogle Scholar
Kessler, R. C., Abelson, J., Demler, O., Escobar, J. I., Gibbon, M. and Guyer, M. E. (2004). Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMHCIDI). International Journal of Methods in Psychiatric Research, 3, 122139.CrossRefGoogle Scholar
Kroenke, K., Spitzer, R., and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613.CrossRefGoogle ScholarPubMed
Kroenke, K., Spitzer, R., Williams, J. B. and Löwe, B. (2010). The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. General Hospital Psychiatry, 32, 345359.CrossRefGoogle ScholarPubMed
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W. et al. (2008). Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care, 46, 266274.CrossRefGoogle ScholarPubMed
MacCallum, R. C., Browne, M. W. and Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1, 130149.CrossRefGoogle Scholar
Mahoney, A., Hobbs, M. J., Newby, J. M., Williams, A. D., Sunderland, M. and Andrews, G. (2016). The Worry Behaviors Inventory: assessing the behavioral avoidance associated with generalized anxiety disorder. Journal of Affective Disorders, 203, 256–64.CrossRefGoogle ScholarPubMed
Mewton, L., Wong, N. and Andrews, G. (2012). The effectiveness of internet cognitive behavioral therapy for generalized anxiety disorder in clinical practice. Depression and Anxiety, 29, 843849.CrossRefGoogle ScholarPubMed
Muthén, L. K. and Muthén, B. O. (1998–2009). Mplus User's Guide. Los Angeles, CA: Muthén & Muthén.Google Scholar
Newby, J. M., Mackenzie, A., Williams, A. D., McIntyre, K., Watts, S., Wong, N. et al. (2013). Internet cognitive behavioral therapy for mixed anxiety and depression: a randomized controlled trial and evidence of effectiveness in primary care. Psychological Medicine, 43, 26352648.CrossRefGoogle ScholarPubMed
Newby, J. M., Mewton, L. and Andrews, G. (2017). Transdiagnostic versus disorder-specific internet-delivered cognitive behavioral treatment for anxiety and depression in primary care. Journal of Anxiety Disorders, 46, 2534.CrossRefGoogle ScholarPubMed
Newby, J. M., Mewton, L., Williams, A. D. and Andrews, G. (2014). Effectiveness of transdiagnostic internet cognitive behavioral treatment for mixed anxiety and depression in primary care. Journal of Affective Disorders, 165, 4552.CrossRefGoogle ScholarPubMed
Robichaud, M. (2013). Cognitive behavior therapy targeting intolerance of uncertainty: application to a clinical case of generalized anxiety disorder. Cognitive and Behavioral Practice, 20, 251263.CrossRefGoogle Scholar
Robinson, E., Titov, N., Andrews, G., McIntyre, K., Schwencke, G. and Solley, K. (2010). Internet treatment for generalized anxiety disorder: a randomized controlled trial comparing clinician vs. technician assistance. PLoS ONE, 5, e10942.CrossRefGoogle ScholarPubMed
Salkovskis, P. M. and Warwick, H. M. (1986). Morbid preoccupations, health anxiety and reassurance: a cognitive-behavioral approach to hypochondriasis. Behavior Research and Therapy, 24, 597602.CrossRefGoogle Scholar
Schut, A. J., Castonguay, L. G. and Borkovec, T. D. (2001). Compulsive checking behaviors in generalised anxiety disorder. Journal of Clinical Psychology, 57, 705715.CrossRefGoogle Scholar
Sexton, K. A. and Dugas, M. J. (2008). The Cognitive Avoidance Questionnaire: validation of the English translation. Journal of Anxiety Disorders, 22, 355370.CrossRefGoogle ScholarPubMed
Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomska, D. E., Woods, S. W. et al. (1997). Multicenter collaborative Panic Disorder Severity Scale. American Journal of Psychiatry, 154, 15711575.CrossRefGoogle ScholarPubMed
Shear, M. K., Rucci, P., Williams, J., Frank, E., Grochocinski, V., Vander Bilt, J. et al. (2001). Reliability and validity of the Panic Disorder Severity Scale: replication and extension. Journal of Psychiatric Research, 35, 293296.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Kroenke, K., Williams, J. B. and Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 10921097.CrossRefGoogle ScholarPubMed
Starcevic, V., Portman, M. E. and Beck, A. T. (2012). Generalized anxiety disorder: between neglect and an epidemic. Journal of Nervous and Mental Disorders, 200, 664667.CrossRefGoogle Scholar
Steiger, J. H. (1980). Tests for comparing elements of a correlation matrix. Psychology Bulletin, 87, 245251.CrossRefGoogle Scholar
Sunderland, M., Slade, T. and Andrews, G. (2012). Developing a short-form structured diagnostic interview for common mental disorders using signal detection theory. International Journal of Methods in Psychiatric Research, 21, 247257.CrossRefGoogle ScholarPubMed
Wells, A. (1995). Meta-cognition and worry: a cognitive model of generalized anxiety disorder. Behavioral and Cognitive Psychotherapy, 23, 301320.CrossRefGoogle Scholar
Wells, A. (1999). A metacognitive model and therapy for generalized anxiety disorder. Clinical Psychology and Psychotherapy, 6, 8695.3.0.CO;2-S>CrossRefGoogle Scholar
Wittkampf, K. A., Naeije, L., Schene, A. H., Huyser, J. and van Weert, H. C. (2007). Diagnostic accuracy of the mood module of the Patient Health Questionnaire: a systematic review. General Hospital Psychiatry, 29, 388395.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.