Validity and Reliability of the Japanese Version of the Cognitive Scale for Functional Bowel Disorders

BackgroundThe Cognitive Scale for Functional Bowel Disorders (CS-FBD) is a useful measure to assess maladaptive cognition, and focuses on how functional bowel disorders relate to negative thoughts, perfectionism, and social desirability. This study aimed to confirm the reliability and validity of the Japanese version of the CS-FBD (CS-FBD-J). MethodsParticipants comprised 192 students (20.2±3.0 years) and 22 outpatients diagnosed with irritable bowel syndrome (IBS) (38.0±13.0 years). There were 76 students who met the diagnostic criteria for IBS, and two students who received treatment for IBS. Participants completed questionnaires containing the CS-FBD-J, IBS Severity Index (IBS-SI), Visceral Sensitivity Index (VSI), 24-item Dysfunctional Attitudes Scale (DAS-24), and Hospital Anxiety and Depression Scale (HADS).ResultsOur factor analysis revealed that the CS-FBD-J had a unidimensional factor structure, and that the factor loadings for 2 out of the 25 items were less than 0.4. After excluding the two items from the analysis, a single factor of the 23-item version accounted for 45.85% of the total variance. The CS-FBD-J scores had significant moderate correlations with the IBS-SI (r = 0.492~0.574) and VSI (r = 0.531~ 0.557) scores in the IBS group and the control group. Correlation between the DAS-24 and the CS-FBD-J was not significant (r = 0.179 ~ 0.191). Although the CS-FBD-J in the IBS group was significantly correlated with HADS-anxiety (r = 0.450) and depression scores (r = 0.357), their intercorrelations in the control group were not significant (r = 0.150 ~ 0.167). In the score comparison of the CS-FBD-J between the IBS patient group, non-patient IBS group (students with IBS except two who received treatment), and control group, there were significant group effects in the CS-FBD-J (IBS patient > non-patient IBS > control). The internal consistencies of the CS-FBD-J were high (α = 0.95). The item-total correlation analysis for the CS-FBD-J showed that the correlations between each item and the total score were significant.ConclusionThis study confirmed the reliability and validity of the 23-item version of the CS-FBS with the deletion of two items with low factor loadings.