Psychology RootsIllness Behavior Questionnaire
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About Illness Behavior Questionnaire
Scale Name
Illness Behavior Questionnaire
Author Details
I. Pilowsky and N.D. Spence
Translation Availability
English
Background/Description
The Illness Behavior Questionnaire (IBQ), developed by I. Pilowsky and N.D. Spence in 1975 and revised in 1983, is a self-administered tool designed to assess maladaptive responses to illness, including hypochondriacal tendencies, denial, and affective changes, to explain exaggerated illness reactions. Published in Journal of Psychosomatic Research (1975, revised 1983), it is widely used in pain studies despite applicability to any illness. The original 52-item version expanded to 62 items (or a 30-item abbreviation), with 10 items from the Whiteley Index of Hypochondriasis, using a yes/no format. Presented as a survey on illness impact, the 62 items are grouped into seven empirically derived dimensions via factor analysis: General Hypochondriasis (phobic health concern), Disease Conviction (symptom focus, doctor reassurance rejection), Psychological vs Somatic Perception (self-blame vs somatization), Affective Inhibition (difficulty expressing feelings), Affective Disturbance (anxiety/sadness), Denial (attributing issues to illness), and Irritability (angry friction).
Scores are calculated by counting “problem” responses (asterisked in the exhibit) for a total, or by dimension, with higher scores indicating maladaptive health perceptions. The IBQ was validated with clinical samples (mean age ≈ 18–65 years, mixed gender, multi-country), correlating with illness behavior patterns. It takes 5–10 minutes to complete and is used in psychology, psychiatry, and pain management to assess illness response styles.
Administration, Scoring and Interpretation
- Obtain the IBQ from Pilowsky and Spence (1975, revised 1983) or Journal of Psychosomatic Research, ensuring ethical permissions.
- Explain to participants (adults 18+ with any illness, especially pain) that the questionnaire explores illness effects, emphasizing confidentiality and voluntary participation.
- Administer the 62-item (or 30-item) self-report scale in clinical or research settings, with respondents answering yes/no to each item.
- Estimated completion time is 5–10 minutes.
- Ensure a private, supportive environment; provide mental health resources (e.g., referrals) and adapt for accessibility (e.g., large print, assistance) if needed.
Reliability and Validity
The IBQ demonstrates solid psychometric properties (Pilowsky & Spence, 1975, 1983). Internal consistency is high (Cronbach’s alpha ≈ 0.80–0.90 across dimensions, N not specified). Test-retest reliability is moderate to high (r ≈ 0.75–0.85) over short intervals. Inter-rater reliability is not applicable due to self-report but is consistent with standardized scoring.
Convergent validity is supported by correlations with the Whiteley Index (r ≈ 0.60–0.80) and pain behavior scales. Discriminant validity is evidenced by its ability to differentiate maladaptive illness responses (e.g., hypochondriasis vs denial), with dimension scores effectively reflecting distinct constructs. Factor analysis confirms the seven-factor structure, supporting construct validity. The IBQ reliably assesses illness behavior. Pairing with the McGill Pain Questionnaire or Zung’s Pain and Distress Scale enhances comprehensive assessment.
Available Versions
52-Items
Reference
Pilowsky, I., & Spence, N. D. (1975). Patterns of illness behaviour in patients with intractable pain. Journal of psychosomatic Research, 19(4), 279-287.
Pilowsky, I. (1983). Manual for the illness bahaviour questionnaire (IBQ). Adelaide.
Important Link
Scale File:
Frequently Asked Questions
What does the IBQ measure?
It measures maladaptive illness responses, including hypochondriasis, denial, and affective changes.
Who is the target population?
Adults (18+) with any illness, particularly pain, in clinical or research settings.
How long does it take to administer?
Approximately 5–10 minutes.
Can it inform interventions?
Yes, it identifies maladaptive responses to guide psychological or medical interventions.
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