Illness Behavior Questionnaire (IBQ) includes seven scales that evaluate abnormal illness behavior, which Pilowsky defined as "the persistence of an inappropriate or maladaptive mode of perceiving, evaluating or acting in relation to one's own state of health despite the fact that a doctor has provided a lucid and accurate appraisal of the situation and management to be followed."
The seven scales of the Illness Behavior Questionnaire are: 1) the general hypochondriasis scale, which assesses the extent of fearful attitudes toward illness that include some insight into the excessive nature of the fear; 2) the disease conviction scale, which measures the strength of the belief that a somatic disorder is present and the degree of reluctance to accept reassurance (questions focused on bodily symptoms and sensations and sleep disturbances); 3) the psychological versus somatic focusing scale, which measures the extent of a psychological versus a somatic focus in perception of the disease (high scores indicate possible adoption of a psychological perspective on the illness; low scores reflect a focus on somatic problems and a tendency to reject the possibility of a psychological dimension to the condition); 4) the affective inhibition scale, on which high scores indicate the inability to communicate feelings, especially negative ones; 5) the affective disturbance scale, which assesses the presence of anxiety, depression, and tension; 6) the denial scale, which measures the tendency to deny life stresses and to attribute all current difficulties to a somatic disorder (high scores indicate a belief that a cure for physical problems would solve all life problems; low scores indicate a belief that ongoing life problems would continue even if the person was physically well); and 7) the irritability scale, on which high scores indicate the presence of interpersonal friction.
Abbreviated Name: IBQ Author(s): Issy Pilowsky, Neil Spence
Purpose: To assess patient's attitudes, ideas, affects, and attributions in relation to illness Population: Adult Age Range : 18+ years Type of Instrument: Quality of life Mode of Administration: Rater:
Time required: Response Options: Scoring:
Score Direction: Number of Items: 62 Original Language: English Existing Translations: Chinese, Dutch, Finnish, German, Greek, Hindi, Italian, Japanese, Norwegian, Polish, Serbo-Croatian, Spanish, Swedish
Contact for information and permission to use:
Professor Issy Pilowsky Visiting Professor
Department of Psychological Medicine University of Sydney
Camperdown New South Wales 2006, Australia Phone:02 98100970 Fax: 9810-1897
E-mail: [email protected]
Self-administered 15 minutes Yes/No
Scores by dimension
- Whiteley Index of Hypochondriasis Score
- Affective State Score
- Disease Affirmation Score
Depending on the score / dimension considered
Dimensions covered by the questionnaire :
• General (phobic) Hypochondriasis
• Disease conviction
• Psychological vs. somatic focussing
• Affective inhibition
• Affective disturbance
1. Pilowsky I, Spence N, Cobb J, Katsikitis M. The Illness Behavior Questionnaire as an aid to clinical assessment. Gen Hosp Psychiatry. 1984 Apr;6(2):123-30.
The Illness Behavior Questionnaire (IBQ) is a 62-item self-report instrument that provides information relevant to the delineation of a patient's attitudes, ideas, affects, and attributions in relation to illness. The scores generated are described, and nine clinical vignettes are presented, together with IBQ score profiles and interpretations to illustrate the manner in which the latter may complement other clinical data. The ways in which individuals react to their own health status is becoming of greater importance as the taking of responsibility for one's own health is increasingly emphasized. The IBQ provides information that should be relevant to the management of patients, regardless of the specific nature of their illness.
2. Pilowsky I, Chapman CR, Bonica JJ. Pain, depression, and illness behavior in a pain clinic population. Pain. 1977 Dec;4(2):183-92.
The relationship between depression, illness behavior and persistent pain was studied in 100 patients referred to the University of Washington Hospital Pain Clinic. The instruments used were the Illness Behavior Questionnaire (IBQ) and the Levine-Pilowsky Depression Questionnaire (LPD). To delineate those aspects of illness behavior characteristic of the Pain Clinic group, their scores were compared to those attained on the IBQ by a Family Medicine Clinic sample. The Pain Clinic group showed greater conviction of disease and somatic preoccupation than the comparison group. Further, they were reluctant to consider their health problems in psychologic terms, and denied current life problems. The Pain Clinic group's performance on the LPD indicated a low degree of depressive affect overall and few patients manifesting a depressive syndrome. The association between IBQ and depression scores suggests that the predominant clinical pattern presented by pain clinic patients is best characterized as a form of "abnormal illness behavior".
3. Pilowsky I, Spence N. Illness behaviour syndromes associated with intractable pain. Pain. 1976; 2:67-71
One hundred patients, referred for the management of intractable pain, completed a 52-item Illness Behaviour Questionnaire (IBQ). Responses were scored on 7 scales: general hypochondriasis, disease conviction, psychological versus somatic perception of illness, affective inhibition, affective disturbance, denial, and irritability. IBQ scale profiles were subjected to numerical analysis and 6 taxonomic clusters were identified. Patients in groups 1-3 were characterized by a relatively non-neurotic, reality-oriented attitude to illness, as indicated by low scores on the first three scales. Patients in groups 4-6 manifested greater evidence of 'abnormal illness behaviour', and presented syndromes resembling 'hysteria', 'conversion reaction', and 'hypothchondriasis' respectively.
4. Pilowsky I. "Abnormal Illness Behaviour" (1997);Wiley and Son: Chichester ISBN: 0-47196573-1
T. Pilowsky and NT). Sperice Inquiries: Dept. of Psychiatry, University of Adelaide, South Australia
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