Factor analysis and reliability of the Illness Attitude Scales in senior medical students

Illness behavior is influenced by subjective, social, and cultural factors and can vary from one person to another and even internally within the same individual depending on the situation and the type of illness he or she needs to deal with. The Illness Attitude Scales (IAS) were designed by Robert Kellner to assess fears, negative beliefs, and attitudes related to hypochondriasis and abnormal behavior in relation to illness, and it is a reliable tool for detecting them as it does not contain items related to symptoms that are characteristic of other psychiatric symptoms. Although the IAS are commonly used, only a few studies have investigated their factor structure, but no common factor solution has been found. The results of these studies differ, ranging from 2 to 5 factor solutions, as well as which items are assigned to the factors. Since factor analysis for the Greek translation has not been previously researched, we analyzed the factor structure in a Greek sample using exploratory factor analysis to reflect cultural nuances in health perceptions and illness behaviors and to enable meaningful comparisons with other populations. A mixed sample of senior medical students of the Athens Medical School (N = 163) completed the psychometric tool before attending the educational clinics. Α percentage of 60.98% were women and 39.02% were men, and the average age of the sample was 23.84 years (SD = 1.67). Data were subjected to Maximum Likelihood Estimation and oblique rotation, which revealed a solution of seven factors: i) Worry about Illness after Pain Sensation, ii) Health Habits, iii) Effects of Symptoms, iv) Hypochondriac Beliefs, v) Thanatophobia, vi) Treatment Experiences, vii) Disease Phobia. The internal consistency of the factors, measured by Cronbach's alpha coefficient, achieved good to acceptable reliability: 0.86, 0.88, 0.68, 0.76, 0.73, 0.65, and 0.81, respectively. The results of the current study, although they cannot be generalized to the general population, provide information on medical students' attitudes towards illness and may pave the way for educational strategies and programs in medical school to improve the detection of negative beliefs and attitudes towards illness in medical students during clinical practice.