ICQ: Illness Cognition Questionnaire for chronic diseases/ ZCL: de Ziekte Cognitie Lijst

The ICQ was developed to measure three generic illness cognitions that reflect different ways of reevaluating the inherently aversive character of a chronic condition: ‘helplessness’ as a way of emphasizing the aversive meaning of the disease, ‘acceptance’ as a way to diminish the aversive meaning, and ‘perceived benefits’ as a way of adding a positive meaning to the disease. The ICQ takes about 5 minutes to complete. Each of the three scales (helplessness, acceptance and benefits) consists of 6 items that are rated according to a 4-point Likert scale to the extent of agreement (1= not at all, 2=somewhat, 3= to a large extent, 4= completely).
Research support the reliable and valid assessment of these illness cognitions and indicate the maladaptive function of helplessness and the adaptive function of acceptance and perceived benefits for the long-term physical and psychological health of patients with a chronic disease. The three-factor structure and the clinical usefulness of the subscale scores was supported in various groups of patients.
The use of the ICQ is free for health professionals and researchers and the questionnaire is available in a Dutch [article in .pdf format], English [article in .pdf format], Finnish [article in pdf format], Hebrew [article in .pdf format], Portugese[article in jpg format][article in jpg format], Greek[article in pdf format] and German [article in .pdf format] version.

Publications

Evers, A.W.M., Kraaimaat, F.W., van Lankveld, W. & Bijlsma, J.W.J. (1998). De Ziekte Cognitie Lijst (ZCL) (The Illness Cognition Questionnaire: ICQ). Gedragstherapie, 31, 205-220 [article in .pdf format].

Evers, A.W.M., Kraaimaat, F.W., van Lankveld, W., Jongen, P.H.J. , Jacobs, W.W.G. & Bijlsma, J.W.J. (2001). Beyond unfavorable thinking: Illness Cognition Questionnaire for chronic diseases. Journal of Consulting and Clinical Psychology, 69, 6, 1026-1036. [article in pdf format]

Lauwerier, E., Crombez, G., Van Damme, S., Goubert, L., Vogelaers, D. & Evers, A.W.M. (2009). The construct validity of the Illness Cognition Questionnaire: The robustness of the three-factor structure across patients with chronic pain and chronic fatigue. International Journal of Behavioral Medicine, 17, 90-96[article in .pdf format].

Publications with the ICQ as a measurement of illness cognitions

Evers, A.W.M., Kraaimaat, F.W., Riel, P.L.C.M. van & Jong A.J.L. de (2002). Tailored cognitive-behavioral therapy in early rheumatoid arthritis for patients at risk: a randomized controlled trial. Pain 100, 141-153.

Lu, Y., Duller, P., van der Valk, P.G.M. & Evers, A.W.M. (2003). Helplessness as predictor of stigmatization in patients with psoriasis and atopic dermatitis. Dermatology and Psychosomatics, 4, 146-150.

Verhaak, C. M., Smeenk, J.M.J., Evers, A.W.M., Minnen van, A., Kremer, A.J.M. & Kraaimaat, F.W. (2005). Predicting emotional response to unsuccessful fertility treatment: A prospective study. Journal of Behavioral Medicine 28, 181-90.

Verhaak, C. M., Smeenk, J.M.J., van Minnen, A., Kremer, A.J.M. & Kraaimaat, F.W. (2005). A longitudinal prospective study on emotional adjustments before, during and after consecutive fertility treatment cycles. Human Reproduction, 20, 8, 2253-2260.

Deurlo, J.A., Ekkelkamp, S., Hartman, E.E., Sprangers, M.A.G. & Aronson, D.C. (2005). Quality of life in adult survivors  of correction of esophageal atresia. Archives of Surgery, 140, 976-980.

Evers, A.W.M., Lu, Y, Duller, P., Valk, P.G.M. van der, Kraaimaat, F.W. & Kerkhof, P.C.M. van der (2005). Common burden of chronic skin diseases? Contributors of psychological distress in adults with psoriasis and atopic dermatitis. British Journal of Dermatology, 152, 1275-1281.

Hartman, E.E., Oort, F.J., Visser, M.R., Sprangers, M.A., Hanneman, M.J.G., Langen, Z.J. de, Heurn, L.W.E. van, Rieu, P.N.M.A., Madern, G.C., Zee, D.C. van der, Looyaard, N., Silfhout-Bezemer, M. & Aronson, D.C. (2006). Explaining change over time in quality of life of adult patients with anorectal malformations or Hirschsprung's disease. Diseases of the Colon & Rectum, 49, 1-8.

Samwel, H.J.A., Evers, A.W.M., Kraaimaat, F.W. & Crul, B.J.P. (2006). The role of helplessness, fear of pain and pain-coping in chronic pain patients. Clinical Journal of Pain, 22, 245-251.

Samwel, H., Kraaimaat, F.W., Crul, B.J.P. & A.W.M. Evers (2007). The role of fear-avoidance and helplessness in explaining functional disability in chronic pain: a prospective study. The International Journal of Behavioral Medicine, 14, 237-241. 

Logie, H., Crombez, G. & Evers, A.W.M. (2007). De Ziekte Cognitie Lijst bij chronische onverklaarde klachten. Psychologie en Gezondheid, 35, 99-106.

Joosten-Weyn Banningh, L.W.A., Kessels, R.P.S., Olde Rikkert, M.G.M., Geeijns-Lanting, C.E. & Kraaimaat, F.W. (2008). A cognitive  behavioral group therapy for patients diagnosed with mild cognitive impairment and significant others: feasability and preliminary results. Clinical Rehabilitation, 22, 731-740.

Oosterhof, J., Samwel, H., Boo, T.M. de, Wilder-Smith, O.H.G., Oostendorp. R.A.B. & Crul, B.J.P. (2008). Predicting outcome of TENS in chronic pain: a prospective randomized, placebo controlled trial. Pain, 136, 11-20.

Maas, M., Taal, E. Linden, S. van der & Boonen, A. (2009). A review of instruments to assess illness representations in patients with rheumatic diseases. Annals Rheumatic Diseases, 68, 305-309.

Samwel, H.J.A., Kraaimaat, F.W., Crul, B.J.P., Dongen, R.D. van & Evers, A.W.M. (2009). Multidisciplinairy allocation of chronic pain treatment: effects of cognitive-behavioral predictors of outcome. British Journal of Health Psychology, 14, 405-421.

Karademas, E. (2010). Illness cognitions as a pathway between religiousness and subjective health in chronic cardiac patients. Journal of Health Psychology, 15, 239-247.

Crombez, G. , Viane, I., Eccleston, C., Devulder, J. & Goubert, L. (2012). Attention to pain and fear in patients with chronic pain. Journal of Behavioral Medicine. DOI 10.1007/s10865-012-9433-1.

Boer, L.M., Daudey, L., Peters, J.B., Molema, J., Prins, J.B. & Vercoulen, J. (2013). Assessing the stages of the grieving process in chronic obstructive pulmonary disease (COPD): Validation of the Acceptance of Disease and Impairments Questionnaire. International Journal of Behavioral Medicine. DOI 10.1007/s12529-01309312-3.

Casier, A., Goubert, L., Gebbart, W.A., De Baets, F., Van Aken, S., Matthys, D & Crombez, G. (2013). Acceptance, well-being and goals in adolescents with chronic illness: a daily process analysis. Psychology & Health, 28, 11, 1337-1351.

Earnshaw, V.A., Smith, L.R., Chaudoir, S.R., Amico, K.R. & Copenhaver, M.M. (2013). HIV stigma mechanisms and well-being among PLWH: A test of the HIV stigma framework. Aids and behavior. DOI 10.1007/s10461-013-0437-9.

Poppe, C., Petrovic, M., Vogelaers, D. & Combrez, G. (2013). Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism. Journal of Psychosomatic Research, 74, 367-372.

Vriezekolk, J.E., Eijsbouts, A.M.M., van Lankveld, W.G.J.M., Beenackers, H., Geenen, R. & van den Ende, C.H.M. (2013). An acceptance-orieneted cognitive-behavioral therapy in multimodal rehabilitation: A pre-post test evaluation in highly distressed patients with rheaumatic diseases. Patient Education and Counseling, 91, 357-363.

Verhoof, E.J.A., Maurice-Stam, H., Heymans, H.S.A., Evers, A.W.M. & Grootenhuis, M.A. (2014). Psycho-social well-being in young adults with chronic illness since childhood: The role of illness cognitions. Child and Adolescent Psychiatry and  Mental Health, 8, 1, 12.

Sint Nicolaas, S.M., Schepers, S.A., Bergh, E.M.M. van den, Evers, A.W.M., Hoogerbrugge, P.M., Grootenhuis, M.A. & Verhaak, C.M. (2016). Ilness cognitions and family adjustment: psychometric properties of the Illness Cognition Questionnaire for parents of a child with cancer. Supportive Care in Cancer, 24, 2, 529-537.

Patel, A., Sharma, P.S., Kumar, P. & Binu, V.S. (2018). Illness cognitions, anxiety, and depression in men and women undergoing fertility treatments: A dyadic approach. Journal of Human Reproduction Science, 11, 180-189.

Vries, A.M. de, Helgeson, V.S., Schulz, T. et al. (2018). Benefit finding in renal transplantation and its association with psychological and clinical correlates: A prospective study. British Journal of Health Psychology. Doi: 10.1111/bjhp.12346.

Aytar, A., Aykul, A., Alintas, A. Tigli, A.A. (2019). Reliability and validity of the Turkish version of the Illness Cognition Questionnaire. Experimental and Aging Research, 45, 4, 1-12.