The factor structure and reliability of the Illness Attitude Scales in a student and a patient sample

BACKGROUND: The Illness Attitude Scales (IAS), designed by Kellner in 1986, assesses fears, beliefs, and attitudes associated with hypochondriasis and abnormal illness behaviour. However, its factor structure is, especially for translations of the IAS, not sufficiently explored. Thus, the present Study aimed to analyse the factor structure of the IAS in a German student and a patient population using exploratory factor analysis. METHODS: A mixed student (N = 296) and a mixed patient (N = 130) sample completed the IAS. The data was submitted to principal components analyses (PCA) with subsequent oblique rotations. From identified factor structures, scales were derived and submitted to reliability analyses as well as to a preliminary validity analysis. RESULTS: The PCA revealed a four-factor solution in the student sample: (1) fear of illness and death; (2) treatment experience; (3) hypochondriacal beliefs; and (4) effect of symptoms. In the patient sample, the data was best explained by a two-factor solution: (1) health related anxiety and (2) effect of symptoms and treatment experience. All scales reached good to acceptable reliability coefficients. The scales derived from the student sample and those derived from the patient sample were able to distinguish between pain patients and a matched group of normal controls. CONCLUSION: Our data suggests that the IAS is in student samples best represented by a four factor-solution and in patient samples by a two-factor-solution.