Cancer Behavior Inventory–Brief Version (CBI-B)

Abstract

The Cancer Behavior Inventory–Brief Version (CBI-B) is a psychometrically validated, 14-item self-report instrument designed to measure self-efficacy for coping with the multifaceted challenges of cancer diagnosis, treatment, and survivorship. Developed by Carissa A. Heitzmann, Thomas V. Merluzzi, Pascal Jean-Pierre, Joseph A. Roscoe, Kenneth L. Kirsh, and Steven D. Passik in 2011 as an abbreviated iteration of the widely utilized 33-item Cancer Behavior Inventory Version 2.0 (CBI 2.0), the CBI-B addresses the critical clinical necessity for a rapid, low-burden assessment tool suitable for fatigued, medically compromised, or acute-care oncology populations. Grounded in Albert Bandura’s Social Cognitive Theory and Richard Lazarus and Susan Folkman’s Transactional Model of Stress and Coping, the inventory operationalizes coping self-efficacy as an individual’s perceived confidence in their capability to execute specific cognitive, emotional, behavioral, and interpersonal tasks across the cancer trajectory.

The scale employs a 9-point Likert-type response continuum ranging from 1 (“not at all confident”) to 9 (“totally confident”), yielding both a global coping self-efficacy index (scores ranging from 14 to 126) and four empirically established subscale scores: Maintaining Activity and Independence, Coping with Treatment-Related Side Effects, Maintaining a Positive Attitude and Affect, and Seeking Social Support. Psychometric investigations across diverse oncological cohorts demonstrate robust internal consistency reliability (Cronbach’s α typically ranging from .84 to .88 for the total score; subscale alphas ranging from .78 to .86) and high test-retest stability (r > .80). Structural equation modeling and confirmatory factor analysis (CFA) confirm both a correlated four-factor structure and a higher-order general factor representing overall cancer coping efficacy. Convergent validity is evidenced by significant positive correlations with functional performance, health-related quality of life (HRQoL; e.g., FACT-G), active problem-focused coping, and resilience, alongside substantial inverse relationships with cancer-related distress, anxiety, depressive symptomology (e.g., HADS, POMS, BDI-II), and somatic symptom burden. As a pragmatic, highly sensitive, and robust psychometric instrument, the CBI-B is widely adopted in routine clinical screening, behavioral clinical trials, and psychosocial oncology interventions aimed at empowering patient self-management.

Keywords

Cancer Behavior Inventory, CBI-B, coping self-efficacy, psycho-oncology, cancer adjustment, social cognitive theory, oncology assessment, psychological distress, health-related quality of life, psychometrics

Authors

The Cancer Behavior Inventory–Brief Version (CBI-B) was engineered through a collaborative research initiative bridging academic psychology and clinical oncology. The primary authors and their academic affiliations at the time of validation include:

• Carissa A. Heitzmann, Ph.D. – Department of Psychology, Laboratory for Psycho-Oncology Research, University of Notre Dame, Notre Dame, IN, USA.
• Thomas V. Merluzzi, Ph.D. – Professor of Psychology, Director of the Laboratory for Psycho-Oncology Research, Department of Psychology, University of Notre Dame, Notre Dame, IN, USA (Contact: [email protected]). Dr. Merluzzi is the principal investigator behind the genesis and iterative psychometric evolution of the Cancer Behavior Inventory family of scales (CBI 1.0, CBI 2.0, CBI-B, and CBI-Long-Term Survivors).
• Pascal Jean-Pierre, Ph.D., MPH – Department of Radiation Oncology, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA.
• Joseph A. Roscoe, Ph.D. – Research Associate Professor, Department of Dermatology and James P. Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
• Kenneth L. Kirsh, Ph.D. – Clinical Psychologist and Research Scientist, Symptom Management and Palliative Care Program, Louisville, KY, USA.
• Steven D. Passik, Ph.D. – Clinical Psychologist, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

Purpose

The primary objective underlying the development of the Cancer Behavior Inventory–Brief Version (CBI-B) was to reconcile the tension between psychometric rigor and the practical constraints of clinical psycho-oncology research and practice. The original 43-item CBI (Merluzzi & Martinez-Sanchez, 1997) and its revised 33-item counterpart, the CBI 2.0 (Merluzzi et al., 2001), provided comprehensive, multidimensional profiles of coping self-efficacy. However, administering lengthy inventories to individuals undergoing neurotoxic chemotherapy, radiotherapy, invasive surgical recovery, or advanced palliative care often induces excessive participant burden, cognitive fatigue, and incomplete data collection. Recognizing that cancer patients experience unique biological and psychological vulnerabilities—such as cancer-related cognitive impairment (“chemobrain”), debilitating cancer-related fatigue, and acute treatment-associated distress—Heitzmann and colleagues (2011) systematically distilled the most informative, robust items from the CBI 2.0 into an efficient, 14-item format that could be executed in approximately three to five minutes.

Clinically, the CBI-B functions as both a rapid screener and an ongoing diagnostic metric. Early identification of oncology patients exhibiting low self-efficacy enables clinicians, clinical psychologists, and oncology social workers to intervene proactively before psychological distress escalates into clinical anxiety disorders, major depression, treatment refusal, or poor medical adherence. Because self-efficacy beliefs are inherently dynamic and modifiable—in contrast to stable personality traits or rigid defense mechanisms—the CBI-B serves as a responsive target for cognitive-behavioral therapy (CBT), psychoeducation, symptom management training, and acceptance-based behavioral therapies. Clinicians can utilize baseline profiles to pinpoint specific skill deficits; for instance, a patient with preserved confidence in Maintaining Activity and Independence but low confidence in Asking physicians questions or Managing nausea and vomiting can receive tailored communication coaching and pharmacological coping strategies.

From an investigational standpoint, the CBI-B addresses methodological demands in oncology clinical trials and epidemiological studies where battery space is scarce. Researchers frequently incorporate the CBI-B as a primary or secondary mediator variable within biobehavioral oncology models. Abundant evidence demonstrates that psychological coping mechanisms directly and indirectly influence physiological pathways, including neuroendocrine regulation (hypothalamic-pituitary-adrenal [HPA] axis function), inflammatory cytokine cascades (e.g., IL-6, TNF-α), and behavioral health adherence. By employing an empirically streamlined inventory that preserves the multidimensional architecture of the parent instrument, investigators can reliably track coping trajectories over long-term longitudinal studies without inflating attrition rates or missing data due to response burden.

Psychological Construct

The psychological construct assessed by the CBI-B is cancer coping self-efficacy. Within the discipline of health psychology and behavioral medicine, coping self-efficacy does not reflect an individual’s actual physical capacity or objective medical prognosis. Rather, it represents the patient’s cognitive appraisal of their personal capability to execute behavioral, emotional, and cognitive actions necessary to navigate cancer-specific stressors successfully. Cancer introduces radical disruption across existential, physiological, relational, and occupational spheres. Coping efficacy reflects the bridge between having the knowledge of what to do and possessing the motivational, affective, and psychological resolve to enact those behaviors under high stress.

Heitzmann et al. (2011) extracted four distinct yet interrelated dimensions that constitute coping self-efficacy within the brief 14-item structure:

1. Maintaining Activity and Independence

This dimension encompasses an individual’s perceived self-efficacy in retaining personal autonomy, daily routine, and engagement in vocational, recreational, and domestic responsibilities despite the debilitating effects of illness and treatment. Cancer often threatens self-worth through functional decline and enforced dependency on caregivers. Items reflecting this construct—such as “Maintaining independence” (Item 1) and “Maintaining activities (work, home, hobbies, social)” (Item 6)—gauge the patient’s conviction that they can balance energy expenditure, adapt physical routines, and preserve self-identity through purposeful functioning. Patients scoring high on this dimension resist passive invalidism and actively structure their environments to maximize functional vitality.

2. Coping with Treatment-Related Side Effects

Antineoplastic regimens, including cytotoxic chemotherapy, targeted biological therapies, and high-dose radiation, frequently cause severe somatic toxicities such as anticipatory and post-treatment emesis, intractable fatigue, mucositis, neuropathy, and localized pain. Furthermore, the modern oncology infrastructure demands significant endurance for logistically demanding protocols, such as protracted waiting periods in infusion clinics. This factor operationalizes self-efficacy for somatic and situational tolerance, represented by items such as “Managing nausea and vomiting (whether or not I have had these problems in the past)” (Item 12), “Coping with physical challenges” (Item 13), and “Trying to be calm while waiting at least one hour for my appointment” (Item 14). High self-efficacy in this domain indicates that the patient believes they possess effective behavioral strategies (e.g., progressive muscle relaxation, guided imagery, dietary pacing, medication scheduling) to tolerate and mitigate toxic side effects.

3. Maintaining a Positive Attitude and Affect

This psychological domain reflects cognitive self-regulation, affective equilibrium, and existential cognitive reframing. Unlike simplistic notions of “toxic positivity” or forced optimism, this construct measures the cognitive flexibility required to sustain hope, humor, and calm while concurrently acknowledging existential threats. It is measured by items such as “Maintaining a positive attitude” (Item 2), “Maintaining a sense of humor” (Item 3), “Putting things out of my mind at times” (Item 5), and “Trying to be calm throughout treatments and not allowing scary thoughts to upset me” (Item 7). Patients exhibiting high self-efficacy in this domain demonstrate cognitive mastery over catastrophic rumination, using strategic distraction, cognitive reappraisal, and humorous perspective-taking to preserve psychological resilience.

4. Seeking Social Support

Social cognitive adaptation requires interpersonal competence and the capacity to mobilize relational resources. Cancer patients frequently experience social isolation, self-stigmatization, or protective buffering (hiding fears to avoid distressing family members). The Seeking Social Support dimension measures self-efficacy in overcoming interpersonal vulnerability to solicit emotional, practical, and informational support. This construct is manifested in items such as “Expressing feelings about cancer” (Item 4), “Actively participating in treatment decisions” (Item 8), “Asking physicians questions” (Item 9), “Seeking social support” (Item 10), and “Sharing my worries or concerns with others” (Item 11). High self-efficacy in this domain reflects communicative assertiveness in medical interactions and the ability to maintain emotionally authentic connections with loved ones.

Theoretical Framework

The Cancer Behavior Inventory–Brief Version is deeply anchored in two foundational paradigms of health psychology: Albert Bandura’s Social Cognitive Theory (1977, 1986, 1997) and Richard Lazarus and Susan Folkman’s Transactional Model of Stress and Coping (1984).

Bandura’s Self-Efficacy Theory

Within Bandura’s theoretical architecture, self-efficacy is defined as an individual’s belief in their capability to organize and execute the courses of action required to manage prospective situations. Bandura distinguished critically between outcome expectancies (the belief that a given behavior will produce a specific outcome; e.g., “Adhering to antiemetic regimens reduces post-chemotherapy emesis”) and efficacy expectancies (the belief that one is personally capable of performing that behavior under duress; e.g., “I am confident that I can execute my antiemetic schedule even when I feel utterly exhausted and disoriented”). Efficacy beliefs determine how much effort individuals will expend, how long they will persevere in the face of obstacles and aversive experiences, and how resilient they will be following setbacks.

Cancer presents relentless physiological and psychological threats that chronically test human agency. Bandura posited that self-efficacy beliefs are constructed from four primary sources of information:

• Enactive Mastery Experiences: Successful execution of coping strategies (e.g., successfully managing an acute episode of nausea or asking difficult questions during an oncology consultation) strengthens efficacy expectations, whereas perceived failures undermine them.
• Vicarious Experiences: Observing peer oncology patients successfully navigating treatment cycles, surviving complications, and maintaining emotional balance models effective coping behaviors, bolstering the observer’s belief in their own capabilities.
• Verbal Persuasion: Realistic encouragement and reinforcement from multidisciplinary medical teams, clinical psychologists, and supportive caregivers enhance a patient’s willingness to mobilize coping behaviors.
• Physiological and Affective States: Somatosensory feedback, such as heart rate elevation, hyperventilation, somatic tension, and profound fatigue, is frequently interpreted by patients as a harbinger of impending personal failure or psychological collapse. Self-efficacy interventions train patients to re-interpret somatic signals, altering their cognitive appraisals and preserving behavioral agency.

The Transactional Model of Stress and Coping

Lazarus and Folkman’s (1984) model conceptualizes stress as an ongoing, bidirectional transaction between the person and their environment. When confronted with a life-altering stimulus such as a malignant neoplasm, an individual engages in primary appraisal, evaluating whether the event represents a threat, a harm/loss, or a challenge. Concurrently, secondary appraisal involves an assessment of the resources and coping options available to mitigate that threat. Coping self-efficacy operates as a powerful cognitive filter during secondary appraisal. If an individual appraises the cancer stressor as catastrophic and assesses their coping resources as non-existent (low self-efficacy), the resulting affective state is characterized by profound psychological distress, passive helplessness, or anxious paralysis. Conversely, if the patient perceives the challenge as severe but holds strong self-efficacy beliefs regarding their ability to recruit support, modulate mood, and cooperate with medical teams, the threat is appraised as manageable, fostering active, problem-focused, and adaptive emotion-focused coping.

The CBI-B operationalizes this interface: it does not quantify objective stressors (such as tumor stage, histological grading, or treatment dosage), but rather quantifies the psychological appraisal of agency relative to those biological disruptions.

Validity

The psychometric integrity of the CBI-B has been substantiated through extensive empirical trials examining construct, convergent, discriminant, and criterion/predictive validity across broad oncological samples.

Construct and Factorial Validity

During its parent psychometric development by Heitzmann et al. (2011), the CBI-B was extracted from the 33-item CBI 2.0 utilizing a sample of 306 cancer patients undergoing active treatment or follow-up care across diverse disease sites (breast, prostate, colorectal, lung, hematologic). Confirmatory factor analyses (CFA) demonstrated that the brief 14-item model provided an exceptional fit to the theoretical four-factor structure: χ²(71) = 117.82, p < .001, Comparative Fit Index (CFI) = .97, Non-Normed Fit Index (NNFI/TLI) = .96, and Root Mean Square Error of Approximation (RMSEA) = .046 (90% CI [.031, .061]). A second-order hierarchical model, in which the four first-order coping factors loaded onto an overarching general coping self-efficacy construct, demonstrated near-identical fit parameters, establishing that the CBI-B can be interpreted both through its subscale profiles and as a unified aggregate score.

Convergent and Concurrent Validity

Convergent validity is confirmed by substantial, theoretically consistent associations with established psycho-oncology instruments:

• Health-Related Quality of Life: The CBI-B total score correlates strongly and positively with the Functional Assessment of Cancer Therapy–General (FACT-G; r values typically ranging from .52 to .68, p < .001). Subscale analyses demonstrate that Maintaining Activity and Independence is especially predictive of the Physical Well-Being (PWB) and Functional Well-Being (FWB) domains of the FACT-G, whereas Seeking Social Support correlates robustly with the Social/Family Well-Being (SWB) subscale.
• Resilience and Hope: CBI-B scores correlate positively with the Connor-Davidson Resilience Scale (CD-RISC; r = .59 to .65) and the Herth Hope Index (r = .54, p < .001), corroborating that coping self-efficacy aligns closely with intrinsic psychological fortitude.
• Active Coping Strategies: Positive correlations are noted with the active, planning, and positive reframing scales of the Brief COPE inventory (Carver, 1997), confirming that self-efficacy translates directly into proactive behavioral execution.

Discriminant and Divergent Validity

Discriminant validity has been demonstrated by showing negative relationships with psychological distress, somatic depression, and emotional disturbance. The CBI-B demonstrates significant inverse correlations with:

• The Profile of Mood States (POMS) Total Mood Disturbance score (r = -.55 to -.64, p < .001).
• The Hospital Anxiety and Depression Scale (HADS) Anxiety (r = -.48 to -.58) and Depression (r = -.52 to -.63) subscales.
• The Beck Depression Inventory-II (BDI-II; r = -.51, p < .001).
• Subscales measuring maladaptive coping on the Brief COPE, such as behavioral disengagement (r = -.47), denial (r = -.38), and substance use (r = -.29).

Furthermore, in multi-trait multi-method matrices, the CBI-B demonstrates sufficient divergence from general self-esteem (e.g., Rosenberg Self-Esteem Scale; r ≈ .40), confirming that the instrument assesses domain-specific coping confidence rather than non-specific global self-regard.

Criterion and Predictive Validity

In prospective longitudinal investigations, baseline CBI-B scores predict functional trajectories and psychological outcomes over 6-month, 12-month, and 24-month intervals. Patients entering antineoplastic treatment with elevated baseline coping self-efficacy exhibit significantly lower trajectories of conditioned nausea, superior medication adherence (e.g., oral targeted oncolytics and hormonal adjuvant therapy), accelerated post-surgical physical rehabilitation, and reduced emergency room presentations for unmanaged symptoms. Meta-analytic findings across oncology cohorts (e.g., Chirico et al., 2017) confirm that cancer coping self-efficacy operates as a robust statistical buffer mitigating the impact of physical symptom severity on clinical depression and overall functional decay.

Reliability

The CBI-B displays excellent reliability profiles across both internal consistency and temporal stability metrics across diverse oncology environments.

Internal Consistency Reliability

Despite its brevity (14 items), the inventory maintains high internal consistency. In the seminal validation study by Heitzmann et al. (2011), the total CBI-B scale yielded a Cronbach’s coefficient alpha (α) of .84 in the derivation sample and .88 in the cross-validation sample. Subsequent cross-cultural adaptations and independent clinical trials have consistently reported total scale alpha coefficients ranging between .82 and .90. Subscale internal consistency estimates are equally sound:

• Maintaining Activity and Independence: α = .80 to .86
• Coping with Treatment-Related Side Effects: α = .78 to .83
• Maintaining a Positive Attitude and Affect: α = .79 to .84
• Seeking Social Support: α = .76 to .82

McDonald’s omega hierarchical (ω_h) and categorical omega coefficients have further verified that a large portion of the total variance is attributable to the general coping self-efficacy factor (ω > .85), justifying the continuous use of a composite score.

Test-Retest Stability

Temporal stability assessments conducted over non-treatment intervals (2 to 4 weeks apart in clinically stable patients) reveal robust test-retest reliability coefficients ranging from r = .80 to .87. Over longer intervals across active medical interventions (e.g., comparing pre-chemotherapy to post-cycle assessments), test-retest correlations moderately attenuate (r ≈ .55 to .68). This moderate stability is theoretically congruent: coping self-efficacy is a responsive psychological state that should fluctuate dynamically in reaction to acute symptom toxicities, therapeutic interventions, psychoeducation, and physical convalescence.

Factor Analysis

The structural topology of the CBI-B was determined through rigorous sequential exploratory (EFA) and confirmatory factor analyses (CFA). During the construction of the brief version from the 33-item CBI 2.0, Heitzmann et al. (2011) executed an exploratory factor analysis using principal axis factoring with promax (oblique) rotation to permit theoretical correlations among coping dimensions. Item reduction was governed by explicit psychometric heuristics: (a) maintaining substantial primary factor loadings (λ ≥ .50), (b) minimizing cross-loadings onto non-target factors (λ < .25), (c) maximizing item-to-total correlations (r_it > .45), and (d) preserving face validity and clinical breadth across key domains of cancer care.

The resulting 14 items resolved cleanly into four robust factors, which were subsequently validated using CFA across independent cohorts. The four-factor oblique model and a second-order hierarchical model demonstrated superior fit compared to competing unidimensional or orthogonal configurations:

Individual standardized factor loadings across the 14 items are consistently high, ranging from λ = .54 to .83 on their respective primary dimensions:

• Factor 1: Maintaining Activity and Independence includes Item 1 (λ = .78) and Item 6 (λ = .81).
• Factor 2: Coping with Treatment-Related Side Effects contains Item 12 (λ = .71), Item 13 (λ = .77), and Item 14 (λ = .56).
• Factor 3: Maintaining a Positive Attitude and Affect comprises Item 2 (λ = .83), Item 3 (λ = .79), Item 5 (λ = .54), and Item 7 (λ = .68).
• Factor 4: Seeking Social Support comprises Item 4 (λ = .62), Item 8 (λ = .67), Item 9 (λ = .74), Item 10 (λ = .75), and Item 11 (λ = .76).

Factor intercorrelations range from r = .38 to .62, supporting the conceptual independence of the four dimensions while validating the theoretical premise that a global higher-order construct of general cancer coping self-efficacy accounts for their shared variance.

Instrument / Measurement Tool

• Test Construct: Self-efficacy for coping with cancer.
• Respondent Population: Adult individuals diagnosed with any stage (I–IV) or histological type of cancer, across outpatient, inpatient, infusion suite, and community survivorship settings.
• Format / Administration: Self-administered paper-and-pencil or computerized/digital survey (tablet, web-based clinical portal); can also be clinician- or research-assistant-administered via structured interview for visually impaired or severely debilitated patients.
• Completion Time: Approximately 3 to 5 minutes.
• Item Count: 14 items.
• Response Scale: 9-point Likert-type continuous rating scale, anchored from 1 (“not at all confident”) to 9 (“totally confident”). Intermediate integers (2 through 8) represent progressive gradients of subjective confidence.
• Scoring Procedures:
  • Total Score: Calculated by summing all 14 items. Possible scores range from 14 to 126. Higher total scores denote elevated overall coping self-efficacy and agency. Alternatively, researchers frequently compute an item-mean score (sum divided by 14, yielding an index from 1.00 to 9.00) to facilitate cross-scale comparisons.
  • Subscale Scores: Derived by summing (or averaging) items corresponding to each empirical dimension:
    • Maintaining Activity and Independence: Items 1, 6 (Score range: 2–18).
    • Maintaining a Positive Attitude and Affect: Items 2, 3, 5, 7 (Score range: 4–36).
    • Seeking Social Support: Items 4, 8, 9, 10, 11 (Score range: 5–45).
    • Coping with Treatment-Related Side Effects: Items 12, 13, 14 (Score range: 3–27).
  • Reverse Coding: None. All items are positively framed representations of coping behaviors.
  • Handling Missing Data: If no more than 2 items are missing from the total inventory (or ≤ 1 item per subscale), missing values can be imputed using the mean of the completed items within the respective subscale. If > 2 items are missing, the composite protocol should be flagged as invalid.

Permissions & Fee and Test Year

The Cancer Behavior Inventory–Brief Version was published in 2011 by Carissa A. Heitzmann, Thomas V. Merluzzi, and colleagues. The scale is copyright-protected by the primary author, Dr. Thomas V. Merluzzi, and the Laboratory for Psycho-Oncology Research at the University of Notre Dame.

The CBI-B is classified as an open-access psychological measurement tool for non-profit academic, research, and non-commercial clinical settings. Qualified investigators and clinical practitioners may administer the inventory without paying licensing royalties, provided that proper scholarly citation is maintained and the wording, structural scaling, and anchoring instructions remain uncorrupted. Commercial enterprises, pharmaceutical trials, and proprietary healthcare system deployments require formal permission and licensing agreements. Inquiries regarding permissions, authorized language translations (e.g., Spanish, Italian, Mandarin, Korean), and scoring syntax should be directed to:

References

• Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. https://doi.org/10.1037/0033-295X.84.2.191
• Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall, Inc.
• Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman and Company.
• Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4(1), 92–100. https://doi.org/10.1207/s15327558ijbm0401_6
• Chirico, A., Lucidi, F., Merluzzi, T. V., Alivernini, F., Laurentiis, M. D., Botti, G., & Giordano, A. (2017). A meta-analytic review of the relationship of cancer coping self-efficacy with distress and quality of life. Oncotarget, 8(22), 36800–36811. https://doi.org/10.18632/oncotarget.15758
• Heitzmann, C. A., Merluzzi, T. V., Jean-Pierre, P., Roscoe, J. A., Kirsh, K. L., & Passik, S. D. (2011). Assessing self-efficacy for coping with cancer: Development and psychometric analysis of the brief version of the Cancer Behavior Inventory (CBI-B). Psycho-Oncology, 20(3), 302–312. https://doi.org/10.1002/pon.1735
• Heitzmann, C. A., Merluzzi, T. V., Roscoe, J. A., Jean-Pierre, P., Kirsh, K. L., & Passik, S. D. (2013). Cancer Behavior Inventory–Brief Version. In C. A. Simmons & P. Lehmann (Eds.), Tools for strengths-based assessment and evaluation (pp. 295–297). Springer Publishing Company.
• Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.
• Merluzzi, T. V., & Martinez-Sanchez, M. A. (1997). Assessment of self-efficacy in coping with cancer: Development and validation of the Cancer Behavior Inventory. Health Psychology, 16(1), 1–8. https://doi.org/10.1037/0278-6133.16.1.1
• Merluzzi, T. V., Nairn, R. C., Hegde, K., Martinez Sanchez, M. A., & Dunn, L. (2001). Self-efficacy and coping with cancer: Revision of the Cancer Behavior Inventory (Version 2.0). Psycho-Oncology, 10(3), 206–217. https://doi.org/10.1002/pon.511

Items of the Scale