Heart-Focused Anxiety in Patients With Noncardiac Chest Pain: Structure and Validity.
Heart-focused anxiety (HFA) is a fear of cardiac sensations driven by worries of physical health catastrophe. HFA is impairing and distressing and has been shown to disproportionately affect individuals with noncardiac chest pain (NCCP), chest pain that persists in the absence of an identifiable source. The Cardiac Anxiety Questionnaire (CAQ) is a measure designed to assess HFA. The aim of this study was to evaluate the psychometric properties and factor structure of the CAQ in a sample of 229 adults diagnosed with NCCP. Results demonstrated that the CAQ is a useful measure of HFA in patients with NCCP and that a four-factor model including fear of cardiac sensations, avoidance of activities that elicit cardiac sensations, heart-focused attention, and reassurance seeking was the best fit for the data. Additionally, associations between CAQ subscales and two measures of health-related behaviors-pain-related interference and health care utilization-provided evidence of concurrent validity. Treatment implications are also discussed.
University of Missouri-St. Louis, MO, USA jared.israel@umsl.edu.
Jared I
JI
Israel
University of Missouri-St. Louis, MO, USA.
Kamila S
KS
White
University of Missouri-St. Louis, MO, USA.
Courtney C
CC
Farmer
University of Missouri-St. Louis, MO, USA.
Caleb M
CM
Pardue
Harvard Medical School, Boston, MA, USA.
Ernest V
EV
Gervino
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D002637:Chest Pain / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D057566:Self Report
Cardiac Anxiety Questionnaire; health care utilization; heart-focused anxiety; noncardiac chest pain; pain-related impairment