title: A Breathlessness Catastrophizing Scale for chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  Catastrophizing about breathlessness may be related to disability in patients with chronic obstructive pulmonary disease (COPD), but assessment options are limited. This study reports the initial validation of a 13-item Breathlessness Catastrophizing Scale (BCS).
  
  
  METHODS
  Pulmonary rehabilitation inpatients completed spirometric, functional performance and questionnaire assessments at admission (N=242) and discharge (n=186).
  
  
  RESULTS
  The BCS comprised a unifactorial scale that demonstrated excellent internal consistency (Cronbach's alpha=.96) and correlated with measures of anxiety sensitivity, depression, and self-efficacy, but not with performance on walk and stair-climbing tests. BCS scores improved robustly with rehabilitation, approaching a medium effect size (d=.43), and demonstrated a modest association with enhanced performance in a stair-climbing test of exercise tolerance.
  
  
  CONCLUSIONS
  The BCS is a reliable measure of catastrophizing in severe COPD that has good convergent validity and sensitivity to change. Its association with functional performance requires further investigation. However, it appears that a high level of catastrophizing about breathlessness is not a barrier to functional improvement with inpatient pulmonary rehabilitation.
authors.affiliation: School of Psychology, University of Ottawa, Canada. Electronic address: brahm.solomon@gmail.com.
authors.forename: Brahm K
authors.initials: BK
authors.lastname: Solomon
authors.affiliation: Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Canada.
authors.forename: Keith G
authors.initials: KG
authors.lastname: Wilson
authors.affiliation: Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Canada.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Henderson
authors.affiliation: Department of Psychology, The Ottawa Hospital, Canada.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Poulin
authors.affiliation: Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Kowal
authors.affiliation: Department of Medicine, University of Ottawa, Canada.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: McKim
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology; D058443:Catastrophization / Q000175:diagnosis* / Q000523:psychology; D003863:Depression / Q000523:psychology; D004417:Dyspnea / Q000523:psychology*; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D020377:Self Efficacy; D013147:Spirometry; D011795:Surveys and Questionnaires
keywords: Anxiety; Catastrophizing; Chronic obstructive pulmonary disease; Depression; Disability; Rehabilitation