The Caregiving Assertiveness Questionnaire (CAQ)<\/strong>, originally conceptualized and validated in Spanish as the Cuestionario de Asertividad en el Cuidado<\/em>, is a psychometric instrument engineered to evaluate interpersonal assertiveness skills specifically operationalized within the informal dementia caregiving context (M\u00e1rquez-Gonz\u00e1lez et al., 2023<\/a>). Developed in response to the recognized limitations of generalized assertiveness inventories when applied to informal family care dynamics, the CAQ specifically captures interpersonal behaviors directed toward both the individual diagnosed with dementia<\/a> and extended family members or collateral caregivers. Grounded conceptually in foundational communication models and existing psychometric frameworks\u2014including the Rathus Assertiveness Schedule (Rathus, 1973<\/a>) and the Social Skills Scale (Escala de Habilidades Sociales<\/em>; Gismero, 2010)\u2014the instrument evaluates behavioral competencies across three empirically derived dimensions: Expressing Discomfort<\/em>, Facing Conflicts<\/em>, and Setting Limits<\/em>.<\/p>\n Comprising 9 items administered via a 4-point Likert-type scale<\/a> ranging from 0 (Never<\/em>) to 3 (Always<\/em>), the CAQ demonstrated robust psychometric viability in an initial validation cohort of community-residing family dementia caregivers recruited throughout the Autonomous Community of Madrid, Spain. Exploratory factor analysis<\/a> supported a parsimonious three-factor solution accounting for 69.63% of the total variance, accompanied by exceptional model fit indices (\u03c7\u00b2(36) = 783.769, p<\/em> < .001; RMSEA = .033, 90% CI [.000, .094]; CFI = 1.00; TLI = .992; SRMR = .028). The global scale exhibited adequate internal consistency (Cronbach\u2019s \u03b1 = .74), with subscale coefficients reflecting factor-specific nuances (\u03b1 = .79 for Expressing Discomfort; \u03b1 = .68 for Facing Conflicts; \u03b1 = .59 for Setting Limits). The CAQ addresses a critical gap in clinical geropsychology, providing a theoretically grounded, brief diagnostic and evaluative tool for interventions targeting caregiver burden, boundary dysregulation, and psychological morbidity<\/span>.<\/p>\n Assertiveness, Caregiving, Setting Limits, Facing Conflicts, Expressing Discomfort, Dementia Caregivers, Psychometrics, Factor Structure, Caregiver Burden, Interpersonal Skills, Family Dynamics, Geropsychology<\/p>\n The Caregiving Assertiveness Questionnaire (CAQ) was developed and validated by a collaborative research consortium specializing in clinical gerontology and caregiver mental health across academic institutions in Madrid, Spain:<\/p>\n Institutional Correspondence Address:<\/strong> Informal caregiving for individuals diagnosed with progressive neurodegenerative conditions, such as Alzheimer’s disease<\/a> and related dementias, represents one of the most psychologically taxing roles in familial life. Caregivers regularly navigate severe emotional distress, neuropsychiatric behavioral symptoms exhibited by the care recipient, structural isolation, and complex negotiations with secondary kin networks. Despite the established clinical value of assertiveness training<\/a> in stress mitigation and depression prevention, assessment has traditionally relied on generic assertiveness inventories. These general measures evaluate context-free social scenarios (e.g., returning defective merchandise or resisting commercial sales pressure), failing to capture the affective ambivalence, relational guilt, and entrenched reciprocal obligations inherent in primary family caregiving.<\/p>\n The primary purpose of the Caregiving Assertiveness Questionnaire (CAQ) is to provide an ecologically valid, psychometrically sound instrument specifically engineered to measure the assertive repertoire of family dementia caregivers within their immediate caregiving ecosystem. By addressing behavioral interactions both with the impaired care recipient and with extended family networks, the CAQ isolates three foundational competencies:<\/p>\n In clinical practice, the CAQ serves as an essential screening and diagnostic tool within multi-component caregiver support programs, cognitive-behavioral therapy (CBT), and acceptance-based geropsychological frameworks. It allows clinicians to identify specific skill deficits, track treatment progress during assertiveness-focused communication modules, and quantitatively monitor gains in boundary management. In research settings, the CAQ facilitates the empirical exploration of the mechanisms through which social competence moderates the relationship between dementia-related stressors, role overload, and clinical endpoints such as institutionalization, anxiety, and caregiver burnout<\/a>.<\/p>\n Assertiveness in family caregiving denotes the behavioral competency to communicate one’s own needs, desires, emotional boundaries, and rights clearly, directly, and respectfully, while simultaneously acknowledging and safeguarding the dignity and rights of others within the care matrix. In dementia care, the exercise of assertiveness diverges sharply from classic corporate or stranger-based paradigms due to the presence of chronic grief, cognitive impairment in the recipient, and established family hierarchies. The CAQ captures this construct through three primary psychological dimensions:<\/p>\n This dimension reflects the caregiver’s ability to articulate personal emotional fatigue, operational strain, frustration, and psychological vulnerability. Within traditional care dynamics, caregivers frequently engage in emotional suppression driven by perceived social norms of self-sacrifice or unexamined cognitive distortions equating distress with moral failing. The inability to express discomfort typically results in emotional exhaustion, somatic complaints, and unexpressed resentment. Conversely, functional assertiveness in this domain involves communicating distress constructively to family members and healthcare professionals without passive aggression or destructive outbursts, thereby mobilizing adaptive informal and formal instrumental support.<\/p>\n The dementia trajectory inevitably generates intra-familial friction regarding medical decisions, financial allocations, institutionalization decisions, and the inequitable distribution of instrumental tasks. The Facing Conflicts<\/em> construct evaluates the caregiver’s disposition to address these contentious matters directly rather than resorting to avoidance, denial, or unilateral overfunctioning. High scorers demonstrate the ability to negotiate disagreements calmly, clarify discordant role expectations among siblings or spouses, and address conflicting views regarding the care recipient’s actual capabilities and care management protocols.<\/p>\n Perhaps the most vulnerable boundary within dementia caregiving involves limit setting. This dimension encapsulates the caregiver’s capacity to decline unreasonable requests, protect personal temporal boundaries, reject unwarranted criticism from peripheral relatives, and balance care duties with self-care routines. Dementia care recipients may manifest repetitive requests, behavioral agitation, or emotional dependence, while extended family may impose unrealistic standards of continuous vigilance. Caregivers deficient in limit-setting skills often experience catastrophic role engulfment, where their personal identity, occupational pursuits, and restorative behaviors are subsumed by care demands.<\/p>\n The theoretical architecture of the CAQ is grounded in behavioral social learning theory, contemporary assertiveness models, and Lazarus and Folkman’s transactional model of stress and coping (Lazarus & Folkman, 1984<\/a>), as integrated into geropsychology via the sociocultural model of caregiver stress (Knight & Sayegh, 2010<\/a>).<\/p>\n Knight and Sayegh’s (2010) integrative model posits that caregiver health outcomes are determined not merely by primary objective stressors (such as the care recipient’s functional and cognitive decline), but crucially by sociocultural values, cognitive appraisals, and the utilization of adaptive coping strategies. Assertiveness represents a proactive, problem-focused coping mechanism that operates on both the appraisal and mediation pathways. Caregivers endowed with assertive behavioral skills appraise high-demand care scenarios as controllable challenges rather than insurmountable threats, thereby maintaining internal locus of control and interrupting the progression toward depressive symptomatology.<\/p>\n Historically, assertiveness assessment grew out of Wolpe’s systematic desensitization models and Rathus’s behavioral formulations (Rathus, 1973<\/a>), operationalizing assertiveness along a continuum from passivity through assertiveness to aggression. Later conceptualizations, such as Gismero’s (2010) Social Skills Scale, established distinct dimensions of social competence, including negative assertion and the defense of personal rights.<\/p>\n M\u00e1rquez-Gonz\u00e1lez et al. (2023) argued that standard social skills formulations fail when applied to familial caregiving because the target of communication is often an impaired relative suffering from memory deficits or altered personality traits, or family members bound by longstanding emotional history. Within this context, non-assertive behaviors\u2014such as self-silencing and unyielding limitlessness\u2014are often incorrectly rationalized as expressions of filial devotion or marital loyalty. The CAQ establishes a domain-specific framework wherein assertiveness is conceptualized not as confrontation, but as a vital mechanism for emotional self-regulation, boundary stabilization, and sustainable caregiving.<\/p>\n The psychometric validation of the Caregiving Assertiveness Questionnaire (CAQ) conducted by M\u00e1rquez-Gonz\u00e1lez et al. (2023)<\/a> provided robust empirical evidence supporting its construct, convergent, and discriminant validity across community-based dementia caregiver samples.<\/p>\n Construct validity was initially verified through structural exploration that revealed a clear, theoretically cohesive three-dimensional architecture. As detailed in Section 9, the structural independence and collective coverage of the three factors\u2014Expressing Discomfort<\/em>, Facing Conflicts<\/em>, and Setting Limits<\/em>\u2014confirm that the questionnaire accurately reflects the multi-faceted behavioral construct of caregiving assertiveness. The substantial proportion of common variance explained (69.63%) supports the questionnaire’s structural validity.<\/p>\n In accordance with Knight and Sayegh’s (2010) stress and coping framework, the construct validity of the CAQ was examined against key psychological variables known to mediate caregiving stress:<\/p>\n The CAQ demonstrated distinct divergence from objective indices of care recipient disability (such as basic activities of daily living [ADLs] or functional impairment staging). This demonstrates that caregiving assertiveness constitutes an independent psychological coping resource rather than a simple artifact of objective contextual dependency or physical care task volume.<\/p>\n The internal consistency of the Caregiving Assertiveness Questionnaire (CAQ) was evaluated within the normative sample of Spanish family dementia caregivers utilizing Cronbach\u2019s alpha<\/a> (\u03b1) coefficients across the global composite and each distinct subscale:<\/p>\n Item-total correlation analyses confirmed that all 9 items contributed positively to overall scale reliability, with corrected item-total correlations exceeding acceptable psychometric standards. These findings support the structural reliability of the instrument for both aggregated research analyses and dimensional clinical profiling.<\/p>\n The empirical determination and structural validation of the CAQ’s dimensional architecture were performed using Exploratory Factor Analysis (EFA)<\/a>, following systematic item-reduction procedures from an initial pool of candidate items.<\/p>\n Principal axis extraction procedures, coupled with oblique rotation to account for expected intercorrelations among social skill domains, isolated a clear three-factor solution. The resulting three-factor structure collectively accounted for 69.63%<\/strong> of the total cumulative variance in assertive behavior:<\/p>\n All 9 retained items exhibited primary factor loadings meeting or exceeding the salient threshold of \u03bb \u2265 .40<\/strong>, with minimal cross-loadings, demonstrating clean simple structure. The goodness-of-fit parameters for the three-factor model indicated an exceptional fit to the empirical data<\/span>:<\/p>\n The Caregiving Assertiveness Questionnaire (CAQ) is structured as follows:<\/p>\n The official, full-text items of the Caregiving Assertiveness Questionnaire (CAQ; Cuestionario de asertividad en el cuidado<\/em>) are proprietary and subject to copyright by the original authors and the journal publisher. Consequently, the verbatim item statements are not reproduced in the open public domain.<\/p>\n Respondents complete the 9-item scale by rating the frequency with which they engage in specific communication behaviors when interacting with the person with dementia or other relatives, using the following 4-point rating system:<\/p>\n The 9 items assess communication across three distinct relational subscales:<\/p>\n To acquire the official Spanish or authorized English questionnaire items and scoring keys for clinical or empirical research, please direct inquiries to the corresponding author, Prof. Mar\u00eda M\u00e1rquez-Gonz\u00e1lez, Department of Biological and Health Psychology, Autonomous University of Madrid (maria.marquez@uam.es<\/a>), or consult the original publication in Behavioral Psychology \/ Psicolog\u00eda Conductual<\/em> (M\u00e1rquez-Gonz\u00e1lez et al., 2023).<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":" The Caregiving Assertiveness Questionnaire (CAQ) is a validated 9-item psychometric scale assessing assertive skills across three dimensions\u2014Expressing Discomfort, Facing Conflicts, and Setting Limits\u2014in family dementia caregivers.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","template":"","categories":[66,20149,306],"tags":[12103,24302,422,24301,24303,10475,6,12104],"class_list":["post-8143","psych_scale","type-psych_scale","status-publish","hentry","category-clinical-psychology","category-geropsychology","category-psychological-assessment","tag-assertiveness","tag-caq","tag-caregiver-burden","tag-caregiving-assertiveness-questionnaire","tag-dementia-caregivers","tag-family-caregiving","tag-psychometrics","tag-social-skills"],"_links":{"self":[{"href":"https:\/\/ashadocs.org\/index.php?rest_route=\/wp\/v2\/psych_scale\/8143","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ashadocs.org\/index.php?rest_route=\/wp\/v2\/psych_scale"}],"about":[{"href":"https:\/\/ashadocs.org\/index.php?rest_route=\/wp\/v2\/types\/psych_scale"}],"author":[{"embeddable":true,"href":"https:\/\/ashadocs.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ashadocs.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=8143"}],"version-history":[{"count":0,"href":"https:\/\/ashadocs.org\/index.php?rest_route=\/wp\/v2\/psych_scale\/8143\/revisions"}],"wp:attachment":[{"href":"https:\/\/ashadocs.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=8143"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ashadocs.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=8143"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ashadocs.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=8143"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}2. Keywords<\/h2>\n
3. Authors<\/h2>\n
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\nProf. Mar\u00eda M\u00e1rquez-Gonz\u00e1lez, PhD
\nAutonomous University of Madrid, School of Psychology
\nCalle Iv\u00e1n Pavlov, 6, Campus de Cantoblanco
\n28049 Madrid, Spain
\nEmail: maria.marquez@uam.es<\/a><\/p>\n4. Purpose<\/h2>\n
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5. Psychological Construct<\/h2>\n
Expressing Discomfort<\/h3>\n
Facing Conflicts<\/h3>\n
Setting Limits<\/h3>\n
6. Theoretical Framework<\/h2>\n
The Sociocultural Stress and Coping Paradigm in Caregiving<\/h3>\n
Behavioral Foundations and Domain-Specific Adaptation<\/h3>\n
7. Validity<\/h2>\n
Construct and Factorial Validity<\/h3>\n
Convergent and Criterion Validity<\/h3>\n
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Discriminant Validity<\/h3>\n
8. Reliability<\/h2>\n
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9. Factor Analysis<\/h2>\n
Factor Extraction and Variance Explained<\/h3>\n
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Factor Loadings and Fit Indices<\/h3>\n
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10. Instrument \/ Measurement Tool<\/h2>\n
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0<\/code> = Never (Nunca<\/em>)<\/li>\n1<\/code> = Sometimes (A veces<\/em>)<\/li>\n2<\/code> = Often (A menudo<\/em>)<\/li>\n3<\/code> = Always (Siempre<\/em>)<\/li>\n<\/ul>\n<\/li>\n\n
11. Permissions & Fee and Test Year<\/h2>\n
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12. References<\/h2>\n
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13. Items of the Scale<\/h2>\n
Instrument Administration and Response Format<\/h3>\n
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Subscale Content Domains<\/h3>\n
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