Cognitive representation of challenging behaviour among staff working with adults with learning disabilities.

Cognitive representations of illness have been identified as a determinant of therapeutic outcomes in a variety of health care settings. This paper describes the development of a Likert-type questionnaire to assess how the concept of challenging behaviour is cognitively represented in staff working with adults with learning disabilities. The Challenging Behaviour Representation Questionnaire (CBRQ) was theoretically derived, drawing on two existing measures: the Illness Perception Questionnaire (IPQ) and the Challenging Behaviour Attributions Scale (CHABA). Items for the questionnaire were generated from responses by 300 direct care staff. The questionnaire shows acceptable levels of internal and external reliability. The questionnaire has face validity and a measure of concurrent validity. There is evidence that challenging behaviour is cognitively represented in care staff in a multi-dimensional way, consistent with other studies in health psychology. This has implications for future staff training in this area.