Development and Validation of the Cognitive Attentional Syndrome Scale 1 Revised–Japanese Version¹

Abstract

Background: The Cognitive Attentional Syndrome Scale 1 Revised (CAS-1R) is a 10-item self-report measure designed to assess dysfunctional metacognition, which is a transdiagnostic predictor of psychological disorders. Dysfunctional metacognition can be broadly classi ed into "cognitive attentional syndrome" and "metacognitive beliefs." In the present study, the CAS-1R was translated into Japanese, and the reliability and validity of the Japanese version of the CAS-1R (CAS-1R-J) were examined in a Japanese community sample.Methods: We recruited 552 Japanese residents via the Internet and received responses from 552 individuals for Time 1 (275 men and 277 women, M age = 39.81, SD = 11.06) and 112 individuals for Time 2. Of these, the data of 87 individuals (46 men and 41 women, M age = 40.31, SD = 10.62) were used to examine test-retest reliability.Results: The results of con rmatory factor analysis indicated that the factor structure (three-factor model) of the CAS-1R-J was appropriate for the data. Each of the subscales of the CAS-1R-J showed good internal consistency. In addition, there was a theoretical relationship between the CAS-1R-J and Metacognition Questionnaire-30, Penn State Worry Questionnaire, Generalized Anxiety Disorder-7 Scale, and Patient Health Questionnaire-9 Scale. Furthermore, the results of the hierarchical logistic regression analysis showed that the CAS-1R-J has discriminant and incremental validity for clinical symptoms.Conclusions: These results indicate that the CAS-1R-J is a valid instrument for assessing state cognitive attentional syndrome and metacognitive beliefs in Japanese individuals. BackgroundMetacognitive therapy (MCT) is an effective psychotherapy for individuals with various psychiatric and psychosomatic disorder symptoms (e.g., generalized anxiety disorder, major depressive disorder) or emotional distress and can help improve patients' quality of life [1][2][3]. MCT is based on the self-regulatory executive function (S-REF) model, which assumes that an in exible and repetitive cognitive style in response to negative thoughts, feelings, and beliefs is the direct cause of clinical symptoms [4]. Such an obsessive information processing style has been termed cognitive attentional syndrome (CAS), which consists of repetitive negative thinking, threat monitoring, and unhelpful coping strategies (i.e., thought suppression, avoidance behavior, and substance use), and has been identi ed as a transdiagnostic factor for various psychiatric and psychosomatic disorders [2]. To promote MCT and basic research into MCT, it was necessary to develop a comprehensive index that measured CAS and metacognitive beliefs, which are beliefs that maintain and worsen CAS.In this context, the Cognitive Attentional Syndrome Scale 1 (CAS-1), and its shortened version, the CAS-1 Revised (CAS-1R), were developed to measure state changes in CAS and metacognitive beliefs in the preceding week [2,5]. Both measures have been validated for psychometric properties [6,7]. A Japanese version of the CAS-1 has been ...