Attempting to develop a questionnaire to assess “Inhibition and Isolation” and “Attitude toward Treatment”

The influence of mental stress on the onset/progression of cancer is not clear, i.e., in re what kind of stress could be a problem, or what kind of state of mind would be preferable. Grossarth-Maticek attempted to explain such issues within his own integrative framework. He hypothesized that “object dependence (OD)”, the tendency for an etc.), is a common element of disease-prone behavioral traits (including cancer), and that the opposite concept of “autonomy”, the ability to autonomously and stably satisfy personal needs and obtain a sense of well-being, is a healthy characteristic (“OD–autonomy axis”). He called the behavior pattern characterized by autonomy “type-IV behavior”, while “type-I behavior”, characterized by strong inhibition in interpersonal relationships, as a cancerprone subconcept of OD, and “type-II behavior”, characterized by overexcitement, as a cardiovascular disease-prone subconcept. These hypotheses were then confirmed through observational studies of human populations and intervention studies using a psychotherapy to enhance autonomy. In addition to type-I behavior, Grossarth-Maticek developed several other scales to assess behavioral characteristics related to cancer incidence/progression, and has obtained epidemiological data to support their validity. However, because the questions were quite intrusive or difficult to answer, they required an interview by a trained evaluator. In addition, the concepts of these scales are apparently similar and overlap, but they are not identical. Therefore, we attempted to organize these concepts and create a questionnaire that, in principle, could be answered in a self-administered manner. In this study, we drafted such a questionnaire and examined its reliability and validity. Researchers familiar with Grossarth’s theory worked together to create a draft questionnaire consisting of 12 items on “Inhibition and Isolation (I&I)” and 4 items on “Attitude toward Treatment (AtoT)”. In addition to this questionnaire, 227 hospital staff and their acquaintances (Sample A) and 107 cancer patients (Sample B) completed a set of self-administered questionnaires on the OD-autonomy axis, health-related QOL, and lifestyle habits. In the analysis, considering the nature of the assumed population, both Samples A and B were used for items related to I&I, and Sample B only was used for AtoT. Through confirmatory factor analysis, a 10-item “I&I” scale and a 4-item “AtoT” scale were constructed. Each of these scales showed high values for both Cronbach's alpha coefficient and the test-retest reliability coefficient. I&I moderately, positively correlated with scales relevant to OD, while they did moderately, inversely with scales representing autonomy. AtoT little correlated with measures related to OD, while it did moderately, positively with measures related to autonomy. I&I inversely correlated with many SF36 subscales, especially with the mental health, and AtoT did weakly, positively with the mental health and vitality subscales. Regarding lifestyle habits, I&I were negatively associated with sleep satisfaction, while AtoT showed no clear association with either habit. In this study, we developed the “I&I; AtoT” questionnaire, which consists of two scales, “I&I” and “AtoT”, and confirmed a certain level of reliability and validity for these scales.