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

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.