title: The cardiac anxiety questionnaire: cross-validation among cardiac inpatients.
abstract: OBJECTIVE
  General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the Dutch version of the Cardiac Anxiety Questionnaire (CAQ), which was specifically designed to assess heart focused anxiety.
  
  
  METHODS
  Two hundred thirty-seven patients admitted for an acute coronary syndrome (ACS) and a control group of 49 patients admitted for an exacerbation of rheumatoid arthritis (RA) completed the CAQ, the Agoraphobic Cognitions Questionnaire, Mobility Inventory, Beck Depression Inventory, Beck Anxiety Inventory, and the State-Trait Anxiety Inventory.
  
  
  RESULTS
  Although the original three-factor solution (fear, avoidance, and attention) was acceptable (model fit parameters: CFI = 0.89 and TLI = 0.87), our data were best explained by a four-factor model including safety seeking behaviors. Internal consistency and test-retest reliability were good. The CAQ had moderate correlations with the other anxiety and depression questionnaires. Recently admitted ACS patients had significantly higher scores than RA patients, even after controlling for general anxiety and depressive symptoms (p < 0.001).
  
  
  CONCLUSIONS
  The CAQ is a reliable and valid instrument to assess cardiac anxiety in patients hospitalized with ACS. These results enable longitudinal studies to examine the relationship of heart-focused anxiety with cardiac prognosis and to evaluate interventions specifically targeted at anxiety in cardiac patients.
authors.affiliation: Department of Psychiatry, Radboud University Nijmegen Medical Centre, The Netherlands. M.H.C.vanBeek@psy.umcn.nl
authors.forename: M H C T
authors.initials: MH
authors.lastname: van Beek
authors.forename: R C Oude
authors.initials: RC
authors.lastname: Voshaar
authors.forename: F M
authors.initials: FM
authors.lastname: van Deelen
authors.forename: A J L M
authors.initials: AJ
authors.lastname: van Balkom
authors.forename: G
authors.initials: G
authors.lastname: Pop
authors.forename: A E M
authors.initials: AE
authors.lastname: Speckens
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000523:psychology*; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000523:psychology*; D009426:Netherlands; D009449:Neurocirculatory Asthenia / Q000175:diagnosis / Q000523:psychology*; D011594:Psychometrics / Q000706:statistics & numerical data; D012016:Reference Values; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires