Cancer Behavior Inventory–Brief Version (CBI-B)

Abstract

The Cancer Behavior Inventory–Brief Version (CBI-B) is a concise, 14-item instrument designed to assess self-efficacy in individuals coping with a cancer diagnosis and its associated treatments. Developed by Heitzmann and colleagues in 2011, the CBI-B serves as a psychometrically sound, shortened alternative to the original Cancer Behavior Inventory (CBI, Version 2.0). It specifically measures an individual’s confidence in performing various adaptive behaviors crucial for managing the physical, emotional, and social challenges inherent in coping with cancer. Its brevity makes it highly suitable for clinical settings and large-scale research studies where time efficiency is paramount.

Keywords

Cancer Behavior Inventory–Brief Version, CBI-B, self-efficacy, coping with cancer, Psycho-Oncology, behavioral assessment, psychological adjustment, scale development.

Authors

Heitzmann, C. A., Merluzzi, T. V., Jean-Pierre, P., Roscoe, J. A., Kirsh, K. L., & Passik, S. D. (2011).

Purpose

The primary purpose of the CBI-B is to quantify the degree of confidence (self-efficacy) a patient has in their ability to successfully execute specific behaviors necessary for effective cancer management and adjustment. These behaviors range from maintaining daily activities and managing physical symptoms to actively participating in treatment decisions and seeking social support.

This instrument is valuable for researchers and clinicians seeking a quick yet reliable measure of coping effectiveness, which is often predictive of psychological distress and quality of life outcomes in oncology patients. By identifying areas where a patient lacks confidence, targeted psychosocial interventions can be developed and implemented.

Construct

The CBI-B measures self-efficacy, a core concept derived from Albert Bandura’s Social Cognitive Theory. Within the context of cancer care, self-efficacy is defined as a patient’s belief in their capacity to organize and execute the courses of action required to manage the demands and stressors associated with their illness and treatment.

The scale operationalizes this construct by focusing on observable and measurable coping behaviors rather than general personality traits. High scores indicate strong coping confidence, suggesting better psychological adjustment and adherence to complex treatment regimens.

Validity

The development of the CBI-B involved rigorous psychometric analysis to ensure its validity. Studies comparing the CBI-B to the original 34-item Cancer Behavior Inventory (CBI Version 2.0) demonstrated strong concurrent validity, indicating that the brief version measures the same underlying construct effectively.

Furthermore, the CBI-B has shown predictive validity, correlating significantly and inversely with measures of psychological distress (e.g., anxiety and depression) and positively with patient-reported quality of life, confirming its ability to assess meaningful patient outcomes in the context of Psycho-Oncology research.

Reliability

Reliability analyses conducted during the scale’s development confirmed its internal consistency. The 14 items of the CBI-B generally exhibit high Cronbach’s alpha coefficients, indicating that the items reliably measure a unified construct of cancer coping self-efficacy. Test-retest reliability has also been established, suggesting stable measurement over time, which is critical for longitudinal studies assessing treatment effects or coping interventions.

Factor Analysis

Although the CBI-B is often used as a unidimensional measure of global coping self-efficacy due to its brevity, the underlying structure often reflects key coping domains derived from the longer CBI version. The original CBI Version 2.0 typically identified several factors, such as:

• Coping with Physical Symptoms (e.g., managing nausea/vomiting, physical challenges).
• Coping with Affective Distress (e.g., maintaining a positive attitude, expressing feelings).
• Active Patient Involvement (e.g., participating in decisions, asking questions).
• Maintenance of Normalcy (e.g., maintaining independence and activities).

The 14 items selected for the CBI-B were chosen specifically because they represented the strongest indicators across these critical domains, ensuring comprehensive coverage despite the reduced length. Confirmatory factor analysis (CFA) often supports a strong higher-order factor representing overall coping competence.

Instrument

Test Type: Self-report psychological inventory measuring domain-specific self-efficacy.

Format: 14 items rated on a 9-point Likert scale.

Language Available: Primarily English, with translations potentially available in research contexts.

Population Group: Individuals diagnosed with cancer (e.g., patients undergoing treatment, survivors).

Age Group: Adults.

Population Details: Applicable across various cancer types and stages, focusing on the behavioral confidence related to illness management.

Test Methodology: Respondents rate their confidence in performing each coping behavior using the scale: 1= not at all confident, to 9= totally confident.

Keywords

Psychosocial oncology, coping behaviors, brief instrument, cancer patients, psychological assessment, health behavior, Health Psychology, psychometrics.

Authors

Author ORCID Identifier: Not provided in source content.

Affiliation Email addresses: [email protected] (T.V. Merluzzi).

Correspondence Address: Not explicitly provided in source content, but corresponding author is T.V. Merluzzi, likely affiliated with the University of Notre Dame at the time of publication.

Permissions & Fee and Test Year

The CBI-B was formally developed and validated in 2011 (Heitzmann et al.). Information regarding specific permissions and fees for clinical or commercial use should be sought directly from the corresponding author, T. V. Merluzzi. The scale is frequently cited and utilized in academic research.

Reference’s

• Merluzzi, T.V., Martinez-Sanchez, M.A. (1997). Assessment of self-efficacy in coping with cancer: Development and validation of the cancer behavior inventory. Health Psychology, 16, 1–8.
• Merluzzi, T.V., Nairn, R.C., Hegde, K., Martinez Sanchez, M.A., Dunn, L. (2001). Self-efficacy and coping with cancer: Revision of the Cancer Behavior Inventory (Version 2.0). Psycho-Oncology, 10(3), 206–217.
• Heitzmann, C. A., Merluzzi, T. V., Jean-Pierre, P., Roscoe, J. A., Kirsh, K. L., & Passik, S. D. (2011). Assessing self-efficacy for coping with cancer: Development and psychometric analysis of the brief version of the Cancer Behavior Inventory (CBI-B). Psycho-Oncology, 20(3), 302–312.
• Heitzmann et al., (2011). Cancer Behavior Inventory–Brief Version. In: Simmons C. A., Lehmann P. (eds). Tools for strengths-based assessment and evaluation, New York, NY: Springer, pp. 295-297. (2013).
• Chirico, A., Lucidi, F., Merluzzi, T., Alivernini, F., et al. (2017). A meta-analytic review of the relationship of cancer coping self-efficacy with distress and quality of life, Oncotarget, 8, 36800-36811. doi: 10.18632/oncotarget.15758.

Items of the Cancer Behavior Inventory–Brief Version (CBI-B)

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

1. Maintaining independence
2. Maintaining a positive attitude
3. Maintaining a sense of humor
4. Expressing feelings about cancer
5. Putting things out of my mind at times
6. Maintaining activities (work, home, hobbies, social)
7. Trying to be calm throughout treatments and not allowing scary thoughts to upset me
8. Actively participating in treatment decisions
9. Asking physicians questions
10. Seeking social support
11. Sharing my worries or concerns with others
12. Managing nausea and vomiting (whether or not I have had these problems in the past)
13. Coping with physical challenges
14. Trying to be calm while waiting at least one hour for my appointment

Rating Scale: 1= not at all confident, to 9= totally confident