Validation of a transdiagnostic measure of fears of recurrence and progression about mental health conditions.

Abstract

Objectives: Fears of recurrence and progression (FORP) in people with mental health conditions are understudied despite predicting poorer psychological outcomes and increased rates of relapse. However, there are no well-validated questionnaires that assess FORP in people with non-psychotic conditions. Moreover, it is not known whether FORP is empirically distinct from mental health anxiety.

Design: Online survey collected data at two time points.

Method: A 40-item FORP About Mental Health Questionnaire (FORP-MHQ) was derived from lived experience interviews. Analyses were conducted with a sample of 865 people with different mental health conditions. Exploratory factor analysis in a randomly split sub-sample (N = 432) yielded a 10-item, single-factor structure that measures FORP severity. Confirmatory factor analysis on these items was conducted in the remaining sample (N = 433). Discriminant and convergent validity, and reliability, analyses were conducted in the complete sample. Measurement invariance was assessed between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across different diagnostic categories.

Results: The 10-item FORP-MHQ demonstrated good structural, convergent and concurrent validity, internal consistency, and test-retest reliability. It was also empirically distinct from mental health anxiety with good discriminant validity. The FORP-MHQ was invariant between men and women, those with and without a history of psychosis or mania, and those with and without diagnoses across diagnostic categories.

Conclusion: The FORP-MHQ is a valid and reliable tool to assess FORP in people with a range of different mental health conditions, both psychotic and non-psychotic.