Document Type
Article
Publication Date
5-5-2026
Abstract
BACKGROUND: Existing mental health self-report measures have been criticized for over-simplification, lack of CF-specific focus, susceptibility to measurement reactivity bias, and conflation of symptoms of anxiety and/or depression with CF-related symptoms and/or treatment side effects. The CF Mental Health and Wellness Questionnaire (CFMHWQ) is a 25-item measure assessing CF-specific mental health burden symptoms.
METHODS: To examine common underlying factors contributing to scores on the CFMHWQ, principal component analysis (PCA) was conducted of all 25 items. We conducted cross-validation of CFMHWQ principal components, examining unadjusted correlations between each principal component, demographic characteristics (age and biological sex), negative affect (mean rank global score combining BDI-II and BAI), psychological flexibility (mean rank global score combining AAQ-II and CFQ), and clinical characteristics.
RESULTS: One hundred twenty-three individuals contributed data for the PCA. A 5-factor model provided the most interpretable structure. Factors appeared to correspond to CF role-related concerns, CF symptomatic burden, social impairments due to CF, behavioral compliance, and coping/personality factors. Greater CF role impairments, behavioral adherence, symptom burden, social impairments, and poorer CF coping are all associated with greater negative affect. Similarly, greater levels of psychological flexibility are associated with lower CF role impairments, social impairments, behavioral adherence, and higher CF coping. Older age was associated with better behavioral adherence, but otherwise demographic factors were unrelated to CFMHWQ scores.
CONCLUSIONS: The CFMHWQ is a promising new self-report measure of CF-specific mental health burden, which associates with negative affect and psychological flexibility. Older age was associated with better behavioral adherence. Finally, more than half reported having undergone a medical procedure they experienced as traumatic, highlighting the importance of measuring the mental health burden of CF. Given the CF-specific nature of items and overfamiliarity with existing measures, we encourage the addition of the CFMHWQ by the CF community.
Recommended Citation
O'Hayer, C. Virginia; Smith, Patrick J.; Genecov, Max J.; Drescher, Christopher F.; Bruschwein, Heather; Nurse, Chelsi N.; Lawliss, Katherine; Esiason, Darcy C.; and Esiason, Gunnar H., "Cystic Fibrosis Mental Health and Wellness Questionnaire - Factors and Properties of a Comprehensive CF-Specific Self-Report Measure" (2026). Department of Psychiatry and Human Behavior Faculty Papers. Paper 91.
https://jdc.jefferson.edu/phbfp/91
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
PubMed ID
42100008
Language
English
Comments
This article is the author's final published version in European Clinical Respiratory Journal, Volume 13, Issue 1, 2026, Article Number 2670025.
The published version is available at https://doi.org/10.1080/20018525.2026.2670025. Copyright © 2026 The Author(s).