Beliefs questionnaire

Abstract

The Beliefs Questionnaire is a specialized, two-part self-report instrument primarily utilized in the assessment and monitoring of cognitive factors associated with Health Anxiety and Hypochondriasis. Developed within the framework of cognitive behavioral research, this scale measures the extent to which individuals experience and believe specific, catastrophic health-related thoughts when they are nervous or concerned about their physical well-being. It is often employed alongside the widely validated Health Anxiety Inventory (HAI) to provide a detailed picture of the patient’s illness beliefs and their impact on anxiety levels.

Keywords

Health Anxiety, Hypochondriasis, Catastrophic Misinterpretation, Illness Beliefs, Cognitive Assessment, Self-report, Cognitive Behavioral Therapy (CBT).

Authors

P.M. Salkovskis, K.A. Rimes, H.M.C. Warwick, D.M. Clark (Attributed based on the foundational work related to the Health Anxiety Inventory, which contextualizes this instrument).

Purpose

The primary purpose of the Beliefs Questionnaire is twofold: first, to quantify the frequency of various catastrophic health-related thoughts (e.g., “I must have a brain tumour,” “I am having a heart attack”) during periods of anxiety; and second, to measure the degree of credibility or conviction the respondent holds for each of these thoughts when they are worried about their health. This dual measurement provides essential information for clinical formulation in CBT, helping clinicians identify and target specific maladaptive beliefs underpinning health anxiety.

Construct

The scale measures the core cognitive construct of Catastrophic Misinterpretation of bodily symptoms, which is central to the maintenance model of health anxiety and hypochondriasis. The items reflect common, negative automatic thoughts concerning specific serious illnesses (e.g., cancer, AIDS, stroke) or imminent physical failure (e.g., breathing failure, heart attack). By assessing both how often these thoughts occur and how strongly they are believed, the questionnaire provides a quantitative measure of the severity and entrenchment of these specific health-related fears.

Validity

Although the provided source content does not detail specific validation statistics exclusively for the Beliefs Questionnaire, its items and scoring methods are derived from and validated within the broader research context of the Health Anxiety Inventory (HAI). The HAI, developed by Salkovskis et al. (2002), demonstrated robust psychometric properties, including strong internal consistency and construct validity. The Beliefs Questionnaire is presumed to share this validity by directly assessing the cognitive component—the catastrophic beliefs—that differentiate individuals with clinical health anxiety from healthy controls. Its use as a measure of treatment process suggests strong sensitivity to change following cognitive interventions.

Reliability

Reliability of the Beliefs Questionnaire, particularly its internal consistency (e.g., Cronbach’s alpha), is typically established through its correlation with the main symptom measures of the HAI. Given its application in assessing the stability of core beliefs—which are generally considered stable but modifiable through treatment—it is expected to demonstrate acceptable test-retest reliability over short periods, particularly when used as a treatment outcome measure sensitive to cognitive restructuring. The two scoring components (frequency and belief) allow for differential reliability assessment of thought occurrence versus conviction strength.

Factor Analysis

A formal factor analysis specific to the Beliefs Questionnaire is not detailed in the source. However, given the content of the 18 items, it is highly likely that they load onto a general factor representing catastrophic illness beliefs. Researchers utilizing the longer, research version of the HAI often use subscales that incorporate these catastrophic ideations, suggesting a strong underlying factor structure related to disease fear and perceived vulnerability. The items cover a range of physiological systems (cardiac, neurological, respiratory), indicating a general factor of fatal illness concern rather than distinct somatic fears.

Instrument

Test Type: Self-report psychological scale for cognitive assessment.

Format: Two-part assessment using two distinct rating scales for the same set of items.

Language Available: English (Implied).

Population Group: Clinical and non-clinical individuals experiencing symptoms of Health Anxiety or Hypochondriasis.

Age Group: Adults.

Population Details: Used primarily in adult mental health settings and research focused on anxiety disorders and somatoform disorders.

Test Methodology: The respondent rates 18 specific catastrophic thoughts using two separate scales:

• The first rating (left side) assesses frequency on a 5-point scale (1=Thought never occurs, 5=Thought always occurs).
• The second rating (right side) assesses belief/conviction on a 0-100 numerical scale (0=I do not believe this thought at all, 10=I am completely convinced this thought is true; note: the source implies a visual analogue scale anchored at 0 and 100, despite the intermediate points listed).

Keywords

Health Anxiety Inventory (HAI), Cognitive model, Automatic thoughts, Illness conviction, Self-rating, DSM-IV criteria, Psychological assessment, Research instrument.

Authors

Author ORCID Identifier: N/A (Information not provided in source).

Affiliation Email addresses: N/A (Information not provided in source).

Correspondence Address: Correspondence is typically handled through the Department of Psychology at King’s College London, where the foundational research was conducted.

Permissions & Fee and Test Year

The Beliefs Questionnaire is often made available by researchers associated with the Centre for Anxiety, Depression, and Trauma (CADAT) at King’s College London. It is generally used freely for non-commercial clinical and research purposes, though formal permission may be required for large-scale commercial studies. The scale is associated with the validation of the Health Anxiety Inventory published in 2002. The original PDF can be downloaded here: Beliefs Questionnaire (PDF 45 kb).

Reference’s

The primary reference detailing the context and development of the related instruments is:

• Salkovskis, P.M., Rimes, K.A., Warwick, H.M.C. & Clark, D.M (2002). The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, Vol. 32, 843-853.

Items of the Beliefs questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

Below are some thoughts or ideas that may go through your mind when you are nervous or when you become concerned about your health. Indicate how often each thought occurs by rating each thought form 1-5 using the scale below. Put your rating on the LEFT hand side of each item.

1. Thought never occurs
2. Thought rarely occurs
3. Thought occurs during half of the times when I am nervous or concerned
4. Thought usually occurs
5. Thought always occurs

When you are worried about your health, how much would you believe each of these thoughts to be true?

Go back and rate each thought by choosing a number from the scale below, and put the number which applies on the dotted line on the RIGHT of the form.

0 10 20 30 40 50 60 70 80 90 100

0= I do not believe this thought at all

100= I am completely convinced this thought is true

_____ I must have a brain tumour	_____
_____ I am ha‎ving a heart attack	_____
_____ I am going to have a stroke	_____
_____ I am about to die	_____
_____ I have a serious brain disease	_____
_____ My breathing is going. to fail	_____
_____ I have cancer	_____
_____ I have a heart condition	_____
_____ These symptoms are getting worse	_____
_____ I have a fatal illness	_____
_____ I have AIDS	_____
_____ I have a muscle wasting disease	_____
_____ I have multiple sclerosis	_____
_____ I have leukemia	_____
_____ I have lung disease	_____
_____ I have a brain haemorrhage	_____
_____ I have a serious infection	_____
_____ I have a serious physical illness	_____