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تحلیل روانسنجی پرسشنامه اجتناب شناختی و رابطة آن با عدم تحمل ابهام، جهتگیری منفی نسبت به مشکل و باورهای مثبت نسبت به نگرانی در بیماران مولتیپل اسکلروزیس | ||
| روانشناسی سلامت | ||
| دوره 15، شماره 57، خرداد 1405، صفحه 109-122 اصل مقاله (1.48 M) | ||
| نوع مقاله: علمی- پژوهشی | ||
| شناسه دیجیتال (DOI): 10.30473/hpj.2026.75372.6294 | ||
| نویسندگان | ||
| رضا رحیمی1؛ علی خدائی* 2 | ||
| 1استادیار، گروه روانشناسی، دانشکده روانشناسی و علوم تربیتی، دانشگاه پیام نور، تهران، ایران. | ||
| 2دانشیار، گروه روانشناسی، دانشکده روانشناسی و علوم تربیتی، دانشگاه پیام نور، تهران، ایران. | ||
| چکیده | ||
| مقدمه: اجتناب شناختی بیانگر راهبردها و تلاشهایی برای پیشگیری از تجارب آزارنده و رخدادهای انگیزانندة اضطراب است. این مطالعه با هدف تحلیل روانسنجی نسخة فارسی پرسشنامة اجتناب شناختی (سیکستان و داگاس، 2008) انجام شد. روش: در این مطالعة توصیفی پیمایشی، 350 نفر از مبتلایان به مالتیپل اسکلروزیس که با استفاده از روش نمونهگیری دردسترس انتخاب شدند، مشارکت کردند. شرکتکنندگان به پرسشنامة اجتناب شناختی، مقیاس عدم تحمل ابهام (فرستون و همکاران، 1994)، پرسشنامه باورهای فراشناخت (ولز و کارتارایتهاتون، 2004) و پرسشنامه جهتگیری منفی نسبت به مشکل (رابیچاوود و دوگاس، 2005)، پاسخ دادند. یافتهها: نتایج روش آماری تحلیل عاملی تاییدی از ساختار پنجعاملی مرتبه اول پرسشنامة اجتناب شناختی شامل فرونشانی فکر، جانشینی فکر، حواسپرتی، اجتناب از محرک های تهدیدگر و انتقالِ تصاویر به افکار، به طور تجربی، حمایت کرد. ضرایب همسانی درونی زیرمقیاسهای وجوة اجتناب شناختی در بازة 86/0 و 92/0 به دست آمد. همچنین، همبستگی بین ابعاد اجتناب شناختی با عدم تحمل ابهام، جهتگیری منفی نسبت به مشکل و جهتگیری مثبت نسبت به نگرانی، از روایی ملاکی پرسشنامة اجتناب شناختی، حمایت کرد. نتیجهگیری: در مجموع، نتایج این پژوهش، با تکرار ساختار عاملی مشتمل بر پنج وجة اجتناب شناختی، ضمن دفاع از اتقان خاستگاه نظری بنای مفهومی سازة اجتناب شناختی و همچنین، تدارک شواهدی مضاعف و ناظر بر مقبولیت مشخصههای فنی روایی و پایایی این ابزار سنجش، استفاده از آن را برای اندازهگیری این راهبرد مقابلهای در مبتلایان به مالتیپل اسکلروزیس، مورد تاکید قرار میدهد. | ||
| کلیدواژهها | ||
| اجتناب شناختی؛ باورهای مثبت نسبت به نگرانی؛ جهتگیری منفی نسبت به مشکل؛ عدم تحمل ابهام؛ مالتیپل اسکلروزیس | ||
| عنوان مقاله [English] | ||
| Psychometric Analysis of the Cognitive Avoidance Questionnaire and it’s Relation with Intolerance of Uncertainty, Negative Problem Orientation and Positive Beliefs to Worry in Multiple Sclerosis Patients | ||
| نویسندگان [English] | ||
| Reza Rahimi1؛ Ali khodaei2 | ||
| 1Assistant Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Payame Noor University, Tehran, Iran. | ||
| 2Associate Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Payame Noor University, Tehran, Iran | ||
| چکیده [English] | ||
| Objective: Avoidance, understood as an attempt to escape internal experiences such as emotions, thoughts, and memories, is generally adaptive but becomes maladaptive when excessive, contributing to the maintenance of anxiety and depression. Within the Third Wave of psychological therapies, growing attention has been directed to emotional, behavioral, and particularly cognitive avoidance (Panjwani et al., 2024). Cognitive avoidance includes strategies such as distraction, thought suppression, and worry, which aim to prevent engagement with unwanted thoughts (Hearn et al., 2018). Evidence shows that thought control strategies are strongly linked to anxiety disorders, where worry is seen as a verbal, problem‑focused chain of negative thoughts. According to the avoidance theory of worry, worry functions to block threatening mental imagery and related autonomic arousal, reducing immediate anxiety but maintaining long‑term vulnerability (Mihailova & Jobson, 2020). To assess this construct, Gosselin et al. (2002) introduced the French Cognitive Avoidance Questionnaire, followed by the English 25‑item, five‑factor version developed by Sexton & Dugas (2008), which demonstrated strong psychometric validity. In individuals with multiple sclerosis, fluctuating disease progression increases intolerance of uncertainty, chronic pain, and anxiety through mechanisms such as cognitive avoidance, negative problem orientation, and positive beliefs to worry (Kusec et al., 2024; Chang, 2024). Given the high uncertainty associated with MS, patients frequently anticipate further functional decline, often relying on avoidance‑oriented coping strategies (Lleraa & Newman, 2023).Because coping resources influence MS outcomes and cognitive avoidance plays a central role in anxiety processes, evaluating the psychometric properties of the Persian Cognitive Avoidance Questionnaire among individuals with MS is essential. This study was therefore conducted to examine its validity and reliability in this population. Method: This descriptive survey study examined the psychometric characteristics of the Persian version of the Cognitive Avoidance Questionnaire (CAQ) among patients with Multiple Sclerosis (MS). A sample of 350 patients (175 women and 175 men) was recruited through convenience sampling from the Iranian MS Society in Tehran. Sample size estimation followed Klein’s (2023) guideline for factor analysis based on the 25‑item CAQ. Several validated psychological instruments were administered. The Intolerance of Uncertainty Scale by Freeston et al. assesses responses to ambiguous situations; prior findings by Buhr & Dugas supported its strong reliability, which was replicated in this study (α=.96). The Metacognition Beliefs Questionnaire by Wells & Cartwright‑Hatton was used, specifically the Positive Beliefs about Worry subscale (α=.95). The Negative Problem Orientation Questionnaire by Robichaud & Dugas showed similarly high reliability (α=.94). The primary instrument, the Cognitive Avoidance Questionnaire, measures five dimensions of cognitive avoidance: thought substitution, converting images into thoughts, distraction, avoidance of threat, and thought suppression. The CAQ was translated and adapted into Persian using a rigorous back‑translation protocol to ensure conceptual and linguistic equivalence. Data analysis employed Classical Test Theory principles, and confirmatory factor analysis using maximum likelihood estimation was conducted. Model fit was evaluated using standard indices (χ², χ²/df, CFI, GFI, AGFI, RMSEA). In alignment with earlier studies by Sexton & Dugas, Gosselin et al., and Latari et al., the five‑factor structure showed satisfactory fit and was retained as the preferred model. Overall, the findings provide strong psychometric support for the Persian CAQ and its associated constructs, highlighting its applicability for MS populations. Results: In this study, data were analyzed using SPSS-26 and AMOS-24. Prior to confirmatory factor analysis, normality and multicollinearity assumptions were tested. Results showed no outliers, acceptable skewness (<|3|) and kurtosis (<|8|) values, and no multicollinearity issues (tolerance >0.1, VIF <3). Three competing models were compared: the independence model, single-factor model, and five-factor model. Results indicated that the five-factor model showed good fit (χ²=1185.96, df=2.69, CFI=0.95, GFI=0.94, AGFI=0.91, RMSEA=0.063), while the single-factor model showed poor fit. Factor loadings ranged from 0.65 to 0.90, all statistically significant (p<0.001). Cronbach's alpha for subscales ranged from 0.86 to 0.92. For criterion validity, significant positive correlations were found between the Cognitive Avoidance Questionnaire dimensions and Intolerance of Uncertainty (r=0.60-0.70), Negative Problem Orientation (r=0.59-0.70), and Positive Worry Orientation (r=0.60-0.67). Conclusion: This study aimed to evaluate the psychometric properties of the Persian version of the Cognitive Avoidance Questionnaire (CAQ) in patients with Multiple Sclerosis (MS). Using confirmatory factor analysis, the findings replicated the original questionnaire’s five‑factor structure, comprising thought suppression, thought substitution, distraction, avoidance of threatening stimuli, and converting images into thoughts. These factors were empirically supported in the MS patient population, indicating that cognitive avoidance in this group is a multidimensional construct. Evidence for criterion validity was demonstrated through significant associations between CAQ subscales and related psychological variables, including intolerance of uncertainty, negative problem orientation, and positive beliefs about worry. These correlations align with cognitive models of psychopathology, suggesting that MS patients’ reliance on maladaptive avoidance strategies may be linked to heightened uncertainty, negative cognitive appraisals, and perceived benefits of worry. The unpredictable and stressful nature of MS symptoms may erode coping resources, thereby increasing dependence on avoidant cognitive responses. Reliability was confirmed through item‑level analyses and internal consistency indices, supporting the Persian CAQ as a stable and coherent measure. The results parallel earlier research validating the multidimensional structure of cognitive avoidance, further reinforcing the theoretical foundation underlying the construct. Despite the positive findings, the study noted limitations, including non‑random sampling from an MS association in Tehran, restricted psychometric assessment methods, and the absence of gender invariance testing. These limitations suggest the need for further research with broader samples and additional methodological approaches. In conclusion, the study provides strong support for the validity and reliability of the Persian CAQ and recommends its use for assessing cognitive avoidance strategies among individuals with Multiple Sclerosis. | ||
| کلیدواژهها [English] | ||
| Cognitive Avoidance, Intolerance of Uncertainty Multiple Sclerosis, Negative Problem Orientation, Positive Beliefs to Worry | ||
| مراجع | ||
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Arbuckle, J. L., & Wothke, W. (1999). Amos 4.0 user’s guide: SPSS. (240-260). Chicago: Small Waters Corporation. Buhr, K., & Dugas, M. J. (2002). The intolerance of uncertainty scale: Psychometric properties of the English version. Behavioral Research and Therapy,40(8),931-945. https://doi.org/10.1016/S0005-7967(01)00092-4 Chang, E. C. (2024). On the added burden of concomitant negative problem orientation and pessimism in predicting depressive symptoms and suicidal behaviors in Latinx young adults. Cognitive Therapy and Research, https://doi.org/10.1007/s10608-024-10509-6. Esnaashari, S., Mohammadkhani, S., & Hassanabadi, H. R. (2017). Cognitive model of anxiety in cancer patients: The role of cognitive and metacognitive components. Health Psychology, 6 (21), 66-85. [In Persian] https://dor.isc.ac/dor/20.1001.1.23221283.1396.6.21.5.7 Freeston, M. H., Rheaume, J., Letarte, H., Dugas, M. J., &Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17, 791-802. https://doi.org/10.1016/0191-8869(94)90048-5 Gosselin, P., Langlois, F., Freeston, M. H., Ladouceur, R., Dugas, M. J., & Pelletier, O. (2002). The CognitiveAvoidance Questionnaire (CAQ): Development and validation among adult and adolescent samples. Journal de Therapie Comportementale et Cognitive, 12, 24–37. https://psycnet.apa.org/record/2003-03161-004 Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis (7th ed., pp. 125–857). Upper Saddle River, NJ: Pearson Prentice Hall. Hearn, C. S., Donovan, C. L., Spence, S. H., & March, S. (2018). Do worry and its associated cognitive variables alter following CBT treatment in a youth population with Social Anxiety Disorder? Results from a randomized controlled trial. Journal of Anxiety Disorders, 53,46-57. https://doi.org/10.1016/j.janxdis.2017.11.005 Kline, R. B. (2023). Principles and practices of Structural Equation Modeling (15nd Eds.). New York: Guilford. Kusec, A., Murphy, F. C., Peers, P. V., & Manly, T. (2024). Measuring intolerance of uncertainty after acquired brain injury: Factor structure, reliability, and validity of the Intolerance of Uncertainty Scale–12. Assessment, 31(4) 794–811. https://doi.org/10.1177/10731911231182693 Latorre, J. M., Nieto, M., Ros, L., Font, M. A., Heras†, J., & Ricarte, J. J. (2020). Cognitive Avoidance Questionnaire: Factor structure psychometric properties. Annals of psychology, 36(3),457-467. https://doi.org/10.6018/analesps.397711 Lleraa, S. J., & Newman, M. G. (2023). Incremental validity of the contrast avoidance model: A comparison with intolerance of uncertainty and negative problem orientation. Journal of Anxiety Disorders,95:102699. https://doi.org/10.1016/j.janxdis.2023.102699 Meyers, L. S., Gamest. G., & Goarin, A. J. (2016). Applied multivariate research, design and interpretation. Thousand oaks. London. New Deihi, Sage publication. Mihailova, S., & Jobson, L. (2020). The impact of depression and culture on responses to intrusive autobiographical memories: Cognitive appraisals, cognitive avoidance, and brooding rumination. British Journal of Clinical Psychology,59,66–79. https://doi.org/10.1111/bjc.12232 Panjwani, A. A., Applebaum, A. J., Revenson, T. A., Erblich, J., & Rosenfeld, B. (2024). Intolerance of uncertainty, experiential avoidance, and trust in physician: a moderated mediation analysis of emotional distress in advanced cancer. Journal of Behavioral Medicine,47,71–81. https://link.springer.com/article/10.1007/s10865-023-00419-5 Pennington, C. R., Oxtoby, M. C. S., & Shaw, D. J. (2023). Social Cognitive Disruptions in Multiple Sclerosis: The role of executive (dys) function. Neuropsychology, 38 (2), 157–168. https://doi.org/10.1037/neu0000917 Rivel, M., Achiron, A., Stern, Y., Zeilig, G., & Defrin, R. (2024). Emotional burden among MS patients: associations between specific chronic pain diagnoses and psychological features. Journal of Neurology, 271:688–698. https://link.springer.com/article/10.1007/s00415-023-12048-8 Robichaud, M., & Dugas, M. J. (2005). Negative problem orientation (Part I): Psychometric properties of a new measure. Behaviour Research and Therapy, 43, 391–401. https://doi.org/10.1016/j.brat.2004.02.007 Sexton, K. A., & Dugas, M. J. (2008). The Cognitive Avoidance Questionnaire: Validation of de English translation. Journal of Anxiety Disorders,22,335-370. https://doi.org/10.1016/j.janxdis.2007.04.005 Shirinzadeh Dastgiri, S., Goodarzi, M. A., Rahimi, C., Naziri, G. (2009). Study of factor structure, validity and reliability of metacognition questionnaire-30. Journal of Psychology, 12, 445-461.[In Persian] https://sid.ir/paper/54377/fa Sparaco, M., Miele, G., Abbadessa, G., Ippolito, D., Trojsi, F., Lavorgna, L., & Bonavita, S. (2022). Pain, quality of life, and religiosity in people with multiple sclerosis. Neurological Sciences, 43,3247–3254. https://link.springer.com/article/10.1007/s10072-021-05759-1 Struijs, S. Y., Lamers, F., Rinck, M., Roelofs, K., Spinhoven, P., & Penninx, B.W. J. (2018). The predictive value of approach and avoidance tendencies on the onset and course of depression and anxiety disorders. Depression and Anxiety, 35, 551-559. https://doi.org/10.1002/da.22760 Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics. (p.934), Boston, MA: Allyn & Bacon. Wells, A., & Cartwright-Hatton, S. (2004). A short form of the metacognitions questionnaire: properties of the MCQ-30. Behavior Research and Therapy, 42(4), 385–96. https://doi.org/10.1016/S0005-7967(03)00147-5 | ||
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آمار تعداد مشاهده مقاله: 14 تعداد دریافت فایل اصل مقاله: 12 |
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